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Appel KS, Nürnberger C, Bahmer T, Förster C, Polidori MC, Kohls M, Kraus T, Hettich-Damm N, Petersen J, Blaschke S, Bröhl I, Butzmann J, Dashti H, Deckert J, Dreher M, Fiedler K, Finke C, Geisler R, Hanses F, Hopff SM, Jensen BEO, Konik M, Lehnert K, de Miranda SMN, Mitrov L, Miljukov O, Reese JP, Rohde G, Scherer M, Tausche K, Tebbe JJ, Vehreschild JJ, Voit F, Wagner P, Weigl M, Lemhöfer C. Definition of the Post-COVID syndrome using a symptom-based Post-COVID score in a prospective, multi-center, cross-sectoral cohort of the German National Pandemic Cohort Network (NAPKON). Infection 2024:10.1007/s15010-024-02226-9. [PMID: 38587752 DOI: 10.1007/s15010-024-02226-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/25/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE The objective examination of the Post-COVID syndrome (PCS) remains difficult due to heterogeneous definitions and clinical phenotypes. The aim of the study was to verify the functionality and correlates of a recently developed PCS score. METHODS The PCS score was applied to the prospective, multi-center cross-sectoral cohort (in- and outpatients with SARS-CoV-2 infection) of the "National Pandemic Cohort Network (NAPKON, Germany)". Symptom assessment and patient-reported outcome measure questionnaires were analyzed at 3 and 12 months (3/12MFU) after diagnosis. Scores indicative of PCS severity were compared and correlated to demographic and clinical characteristics as well as quality of life (QoL, EQ-5D-5L). RESULTS Six hundred three patients (mean 54.0 years, 60.6% male, 82.0% hospitalized) were included. Among those, 35.7% (215) had no and 64.3% (388) had mild, moderate, or severe PCS. PCS severity groups differed considering sex and pre-existing respiratory diseases. 3MFU PCS worsened with clinical severity of acute infection (p = .011), and number of comorbidities (p = .004). PCS severity was associated with poor QoL at the 3MFU and 12MFU (p < .001). CONCLUSION The PCS score correlated with patients' QoL and demonstrated to be instructive for clinical characterization and stratification across health care settings. Further studies should critically address the high prevalence, clinical relevance, and the role of comorbidities. TRAIL REGISTRATION NUMBER The cohort is registered at www. CLINICALTRIALS gov under NCT04768998.
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Affiliation(s)
- Katharina S Appel
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany.
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Carolin Nürnberger
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Bahmer
- Internal Medicine Department I, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Christian Förster
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Maria Cristina Polidori
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Mirjam Kohls
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Tanja Kraus
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Nora Hettich-Damm
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Julia Petersen
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Sabine Blaschke
- Emergency Department, University Medical Center Göttingen, Göttingen, Germany
| | - Isabel Bröhl
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jana Butzmann
- Medical Faculty, Institute of Medical Microbiology and Hospital Hygiene, University Hospital Magdeburg, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | - Hiwa Dashti
- Practice for General Medicine Dashti, Eberswalde, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Karin Fiedler
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Carsten Finke
- Department of Neurology, Charité Berlin, Berlin, Germany
| | - Ramsia Geisler
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Frank Hanses
- Emergency Department and Department for Infection Control an Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Sina M Hopff
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Björn-Erik O Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Düsseldorf University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Margarethe Konik
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Duisburg-Essen, Essen, Germany
| | - Kristin Lehnert
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Susana M Nunes de Miranda
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Lazar Mitrov
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Olga Miljukov
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Jens-Peter Reese
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Gernot Rohde
- Department of Respiratory Medicine, Goethe University Frankfurt, University Hospital, Medical Clinic I, Frankfurt/Main, Germany
| | - Margarete Scherer
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Kristin Tausche
- Department of Internal Medicine I, University Hospital Carl Gustav Carus TU Dresden, Dresden, Germany
| | - Johannes J Tebbe
- Department of Gastroenterology and Infectious Diseases, Klinikum Lippe, Lippe, Germany
| | - Jörg Janne Vehreschild
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Florian Voit
- Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Patricia Wagner
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Martin Weigl
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany
| | - Christina Lemhöfer
- Institute of Physical and Rehabilitation Medicine, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
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Brinkmann F, Friedrichs A, Behrens GM, Behrens P, Berner R, Caliebe A, Denkinger CM, Giesbrecht K, Gussew A, Hoffmann AT, Hojenski L, Hovardovska O, Dopfer-Jablonka A, Kaasch AJ, Kobbe R, Kraus M, Lindner A, Maier C, Mitrov L, Nauck M, de Miranda SN, Scherer M, Schmiedel Y, Stahl D, Timmesfeld N, Toepfner N, Vehreschild J, Wohlgemuth WA, Petersmann A, Vehreschild MJGT. Prevalence of infectious diseases, immunity to vaccine-preventable diseases and chronic medical conditions among Ukrainian refugees in Germany - A cross sectional study from the German Network University Medicine (NUM). J Infect Public Health 2024; 17:642-649. [PMID: 38458134 DOI: 10.1016/j.jiph.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Vulnerability to infectious diseases in refugees is dependent on country of origin, flight routes, and conditions. Information on specific medical needs of different groups of refugees is lacking. We assessed the prevalence of infectious diseases, immunity to vaccine-preventable diseases, and chronic medical conditions in children, adolescents, and adult refugees from Ukraine who arrived in Germany in 2022. METHODS Using different media, we recruited Ukrainian refugees at 13 sites between 9-12/2022. An antigen test for acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, serologies for a range of vaccine-preventable diseases, as well as interferon gamma release assays (IGRAs) for tuberculosis (TB), and SARS-CoV-2 were performed. We assessed personal and family history of chronic medical conditions, infectious diseases, vaccination status, and conditions during migration. RESULTS Overall, 1793 refugees (1401 adults and 392 children/adolescents) were included. Most participants were females (n = 1307; 72·3%) and from Eastern or Southern Ukraine. TB IGRA was positive in 13% (n = 184) of the adults and in 2% (n = 7) of the children. Serology-based immunological response was insufficient in approximately 21% (360/1793) of the participants for measles, 32% (572/1793) for diphtheria, and 74% (1289/1793) for hepatitis B. CONCLUSIONS We show evidence of low serological response to vaccine-preventable infections and increased LTBI prevalence in Ukrainian refugees. These findings should be integrated into guidelines for screening and treatment of infectious diseases in migrants and refugees in Germany and Europe. Furthermore, low immunity for vaccine-preventable diseases in Ukrainians independent of their refugee status, calls for tailor-made communication efforts.
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Affiliation(s)
- Folke Brinkmann
- University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Anette Friedrichs
- Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Georg Mn Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany; German Center for Infection Research, Site Hannover-Braunschweig, Hannover, Germany
| | - Pia Behrens
- Goethe University Frankfurt, University Hospital Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany
| | - Reinhard Berner
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Amke Caliebe
- Institute of Medical Informatics and Statistics, Kiel University and University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claudia M Denkinger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infection Research, partner site Heidelberg, Germany
| | - Katharina Giesbrecht
- Goethe University Frankfurt, University Hospital Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany
| | - Alexander Gussew
- Clinic and Policlinic of Radiology, University Medical Clinic Halle, Halle (Saale), Germany
| | - Anna Theresa Hoffmann
- University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Leonhard Hojenski
- Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Olga Hovardovska
- Department of Epidemiology, Helmholtz Centre for Infection Research Braunschweig, Germany; German Centre for Infection Research, TI BBD, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany; German Center for Infection Research, Site Hannover-Braunschweig, Hannover, Germany
| | - Achim J Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Faculty of Medicine, Otto-von-Guericke-University Magdeburg
| | - Robin Kobbe
- Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Monika Kraus
- Institute of Epidemiology, Helmholtz Zentrum München, Munich, Germany
| | - Andreas Lindner
- Charité - Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Christoph Maier
- University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Lazar Mitrov
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine of Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovacsular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Susana Nunes de Miranda
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | - Margarete Scherer
- Goethe University Frankfurt, University Hospital Frankfurt, Department II of Internal Medicine, Hematology/Oncology, Frankfurt am Main, Germany
| | - Yvonne Schmiedel
- Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Dana Stahl
- Trusted Third Party of the University Medicine Greifswald, Greifswald, Germany
| | - Nina Timmesfeld
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Janne Vehreschild
- DZHK (German Centre for Cardiovacsular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Walter A Wohlgemuth
- Clinic and Policlinic of Radiology, University Medical Clinic Halle, Halle (Saale), Germany
| | - Astrid Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine of Greifswald, Greifswald, Germany; Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
| | - Maria J G T Vehreschild
- Goethe University Frankfurt, University Hospital Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany.
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Scherer M, Crompton D, Milosevic L. A phenomenological model of deep brain stimulation induced finely tuned gamma oscillations in the subthalamic nucleus. Brain Stimul 2024; 17:485-487. [PMID: 38685259 DOI: 10.1016/j.brs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 05/02/2024] Open
Affiliation(s)
- M Scherer
- Krembil Brain Institute, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada; Institute of Biomedical Engineering, University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
| | - D Crompton
- Krembil Brain Institute, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada; Institute of Biomedical Engineering, University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
| | - L Milosevic
- Krembil Brain Institute, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada; Institute of Biomedical Engineering, University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada; KITE Research Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
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4
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Hajek A, Petersen E, Schäfer I, Harth V, Koch-Gromus U, Härter M, Schulz H, Scherer M, König HH. Is loneliness associated with cancellation of medical appointments during the COVID-19 pandemic? Evidence from the Hamburg City Health Study (HCHS). BMC Health Serv Res 2024; 24:32. [PMID: 38178105 PMCID: PMC10768441 DOI: 10.1186/s12913-023-10490-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic engendered numerous societal and economic challenges in addition to health-related concerns. Maintenance of healthcare utilization assumed immense significance during this period. However, few studies have examined the association between loneliness and cancelled medical appointments during the COVID-19 pandemic. This study aimed to examine whether medical appointments are less likely to be cancelled with increased loneliness during a pandemic. We analyzed the association between loneliness and both patient- and provider-initiated appointment cancellations. METHODS Cross-sectional data from the Hamburg City Health Study (HCHS) were collected during April 2020-November 2021. The analytical sample included 1,840 participants with an average age of 55.1 years (standard deviation: 6.5, range 45-76 years). Medical appointments cancelled by individuals-medical appointments in general, and GP, specialist, and dentist appointments-and appointments cancelled by healthcare providers served as outcome measures. Loneliness was quantified using a single item ranging from 0 to 10. Accordingly, we created empirical loneliness tertiles. Covariates were selected based on the Andersen model. Several penalized maximum likelihood logistic regressions were utilized to examine the association between loneliness and cancellation of medical appointments during the COVID-19 pandemic. RESULTS The penalized maximum likelihood logistic regressions showed that, compared to individuals in the lowest loneliness tertiles, individuals in the other two tertiles reported a higher chance of medical appointments cancellation by individuals, particularly driven by cancelled GP appointments. Except for age and sex, none of the covariates were comparably associated with the outcomes. When appointments cancelled by healthcare providers served as outcomes, only a higher number of chronic conditions was significantly positively associated with it. CONCLUSIONS Individuals scoring higher in loneliness had a greater chance of cancelling medical (particularly GP) appointments. This may contribute to a potential cascade of loneliness and skipped medical appointments in the future, resulting in adverse health outcomes over the medium-to-long term. Future research should examine whether lonely people are more likely to lack the social motivation to visit the doctor.
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Affiliation(s)
- A Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - E Petersen
- Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Schäfer
- Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - U Koch-Gromus
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H H König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Scherer M, Harmsen IE, Samuel N, Elias GJB, Germann J, Boutet A, MacLeod CE, Giacobbe P, Rowland NC, Lozano AM, Milosevic L. Oscillatory network markers of subcallosal cingulate deep brain stimulation for depression. Brain Stimul 2023; 16:1764-1775. [PMID: 38061548 PMCID: PMC10947774 DOI: 10.1016/j.brs.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/12/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Identifying functional biomarkers related to treatment success can aid in expediting therapy optimization, as well as contribute to a better understanding of the neural mechanisms of the treatment-resistant depression (TRD) and subcallosal cingulate deep brain stimulation (SCC-DBS). Magnetoencephalography data were obtained from 16 individuals with SCC-DBS for TRD and 25 healthy subjects. The first objective of the study was to identify region-specific oscillatory modulations that both (i) discriminate individuals with TRD (with SCC-DBS OFF) from healthy controls, and (ii) discriminate TRD treatment responders from non-responders (with SCC-DBS ON). The second objective of this work was to further explore the effects of stimulation intensity and frequency on oscillatory activity in the identified brain regions of interest. Oscillatory power analyses led to the identification of brain regions that differentiated responders from non-responders based on modulations of increased alpha (8-12 Hz) and decreased gamma (32-116 Hz) power within nodes of the default mode, central executive, and somatomotor networks, Broca's area, and lingual gyrus. Within these nodes, it was also found that low stimulation frequency had stronger effects on oscillatory modulation than increased stimulation intensity. The identified functional network biomarkers implicate modulation of TRD-related activity in brain regions involved in emotional control/processing, motor control, and the interaction between speech, vision, and memory, which have all been implicated in depression. These electrophysiological biomarkers have the potential to be used as functional proxies for therapy optimization. Additional stimulation parameter analyses revealed that oscillatory modulations can be strengthened by increasing stimulation intensity or reducing frequency, which may represent potential avenues of direction in non-responders.
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Affiliation(s)
- M Scherer
- Krembil Brain Institute, University Health Network, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada
| | - I E Harmsen
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Mitchell Goldhar MEG Unit, University Health Network, Toronto, Canada
| | - N Samuel
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - G J B Elias
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - J Germann
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - A Boutet
- Krembil Brain Institute, University Health Network, Toronto, Canada; Joint Department of Medical Imaging, University of Toronto, Canada
| | - C E MacLeod
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - P Giacobbe
- Department of Psychiatry, Sunnybrook Health Sciences, University of Toronto, Toronto, Ontario, Canada
| | - N C Rowland
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA; Murray Center for Research on Parkinson's Disease and Related Disorders, Medical University of South Carolina, Charleston, SC, USA
| | - A M Lozano
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, Canada
| | - L Milosevic
- Krembil Brain Institute, University Health Network, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, Canada; KITE Research Institute, University Health Network, Toronto, Canada.
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6
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Tilch K, Hopff SM, Appel K, Kraus M, Lorenz-Depiereux B, Pilgram L, Anton G, Berger S, Geisler R, Haas K, Illig T, Krefting D, Lorbeer R, Mitrov L, Muenchhoff M, Nauck M, Pley C, Reese JP, Rieg S, Scherer M, Stecher M, Stellbrink C, Valentin H, Winter C, Witzenrath M, Vehreschild JJ. Ethical and coordinative challenges in setting up a national cohort study during the COVID-19 pandemic in Germany. BMC Med Ethics 2023; 24:84. [PMID: 37848886 PMCID: PMC10583323 DOI: 10.1186/s12910-023-00959-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023] Open
Abstract
With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global researchers were confronted with major challenges. The German National Pandemic Cohort Network (NAPKON) was launched in fall 2020 to effectively leverage resources and bundle research activities in the fight against the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the setup phase of NAPKON as an example for multicenter studies in Germany, highlighting challenges and optimization potential in connecting 59 university and nonuniversity study sites. We examined the ethics application process of 121 ethics submissions considering durations, annotations, and outcomes. Study site activation and recruitment processes were investigated and related to the incidence of SARS-CoV-2 infections. For all initial ethics applications, the median time to a positive ethics vote was less than two weeks and 30 of these study sites (65%) joined NAPKON within less than three weeks each. Electronic instead of postal ethics submission (9.5 days (Q1: 5.75, Q3: 17) vs. 14 days (Q1: 11, Q3: 26), p value = 0.01) and adoption of the primary ethics vote significantly accelerated the ethics application process. Each study center enrolled a median of 37 patients during the 14-month observation period, with large differences depending on the health sector. We found a positive correlation between recruitment performance and COVID-19 incidence as well as hospitalization incidence. Our analysis highlighted the challenges and opportunities of the federated system in Germany. Digital ethics application tools, adoption of a primary ethics vote and standardized formal requirements lead to harmonized and thus faster study initiation processes during a pandemic.
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Affiliation(s)
- Katharina Tilch
- Faculty of Medicine, Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf, University of Cologne, University Hospital Cologne, Cologne, Germany.
| | - Sina M Hopff
- Faculty of Medicine, Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Katharina Appel
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Monika Kraus
- Helmholtz Center Munich, Institute of Epidemiology, Research Unit Molecular Epidemiology, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
| | - Bettina Lorenz-Depiereux
- Helmholtz Center Munich, Institute of Epidemiology, Research Unit Molecular Epidemiology, Munich, Germany
| | - Lisa Pilgram
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gabi Anton
- Helmholtz Center Munich, Institute of Epidemiology, Research Unit Molecular Epidemiology, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Sarah Berger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Department of Infectious Diseases, Respiratory Medicine and Critical Care, Berlin, Germany
| | - Ramsia Geisler
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Kirsten Haas
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Julius Maximilian University of Würzburg, Würzburg, Germany
- University Hospital Würzburg, Institute for Medical Data Science (ImDS), Josef-Schneider Straße 2, 97080, Würzburg, Germany
| | - Thomas Illig
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Dagmar Krefting
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Roberto Lorbeer
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
- Deutsches Herzzentrum der Charité, Medical Heart Center of Charité and German Heart Institute Berlin, Institute of Computer-Assisted Cardiovascular Medicine, Berlin, Germany
- Department of Radiology, University Hospital LMU Munich, Munich, Germany
| | - Lazar Mitrov
- Faculty of Medicine, Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Maximilian Muenchhoff
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Max Von Pettenkofer Institute & GeneCenter, Virology, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christina Pley
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Department of Infectious Diseases, Respiratory Medicine and Critical Care, Berlin, Germany
| | - Jens-Peter Reese
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Julius Maximilian University of Würzburg, Würzburg, Germany
- University Hospital Würzburg, Institute for Medical Data Science (ImDS), Josef-Schneider Straße 2, 97080, Würzburg, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Margarete Scherer
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Melanie Stecher
- Faculty of Medicine, Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf, University of Cologne, University Hospital Cologne, Cologne, Germany
- German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany
| | - Christoph Stellbrink
- Bielefeld University, Medical School and University Medical Center East Westphalia-Lippe, Klinikum Bielefeld, Academic Department of Cardiology and Internal Intensive Care Medicine, Bielefeld, Germany
| | - Heike Valentin
- Trusted Third Party of the University Medicine Greifswald, Ellernholzstr. 1-2, 17475, Greifswald, Germany
| | - Christof Winter
- School of Medicine, Institute of Clinical Chemistry and Pathobiochemistry, Technical University of Munich, Munich, Germany
- TranslaTUM, Center for Translational Cancer Research, Technical University of Munich, Munich, Germany
| | - Martin Witzenrath
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Department of Infectious Diseases, Respiratory Medicine and Critical Care, Berlin, Germany
- German Center for Lung Research (DZL), Berlin, Germany
| | - J Janne Vehreschild
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
- German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany
- Department I for Internal Medicine, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
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Yusuf KO, Chaplinskaya-Sobol I, Schoneberg A, Hanss S, Valentin H, Lorenz-Depiereux B, Hansch S, Fiedler K, Scherer M, Sikdar S, Miljukov O, Reese JP, Wagner P, Bröhl I, Geisler R, Vehreschild JJ, Blaschke S, Bellinghausen C, Milovanovic M, Krefting D. Impact of Clinical Study Implementation on Data Quality Assessments - Using Contradictions within Interdependent Health Data Items as a Pilot Indicator. Stud Health Technol Inform 2023; 307:152-158. [PMID: 37697849 DOI: 10.3233/shti230707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
INTRODUCTION Contradiction is a relevant data quality indicator to evaluate the plausibility of interdependent health data items. However, while contradiction assessment is achieved using domain-established contradictory dependencies, recent studies have shown the necessity for additional requirements to reach conclusive contradiction findings. For example, the oral or rectal methods used in measuring the body temperature will influence the thresholds of fever definition. The availability of this required information as explicit data items must be guaranteed during study design. In this work, we investigate the impact of activities related to study database implementation on contradiction assessment from two perspectives including: 1) additionally required metadata and 2) implementation of checks within electronic case report forms to prevent contradictory data entries. METHODS Relevant information (timestamps, measurement methods, units, and interdependency rules) required for contradiction checks are identified. Scores are assigned to these parameters and two different studies are evaluated based on the fulfillment of the requirements by two selected interdependent data item sets. RESULTS None of the studies have fulfilled all requirements. While timestamps and measurement units are found, missing information about measurement methods may impede conclusive contradiction assessment. Implemented checks are only found if data are directly entered. DISCUSSION Conclusive contradiction assessment typically requires metadata in the context of captured data items. Consideration during study design and implementation of data capture systems may support better data quality in studies and could be further adopted in primary health information systems to enhance clinical anamnestic documentation.
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Affiliation(s)
- Khalid O Yusuf
- Department of Medical Informatics, University Medical Center Göttingen, Germany
| | | | - Anne Schoneberg
- Department of Medical Informatics, University Medical Center Göttingen, Germany
| | - Sabine Hanss
- Department of Medical Informatics, University Medical Center Göttingen, Germany
- German Center for Cardiovascular Research, Partner Site Göttingen, Germany
| | - Heike Valentin
- Trusted Third Party of the University Medicine Greifswald, Germany
| | | | - Stefan Hansch
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Germany
| | - Karin Fiedler
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Frankfurt am Main, Germany
| | - Margarete Scherer
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Frankfurt am Main, Germany
| | - Shimita Sikdar
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Frankfurt am Main, Germany
| | - Olga Miljukov
- University of Würzburg, Institute for Clinical Epidemiology and Biometry
| | - Jens-Peter Reese
- University of Würzburg, Institute for Clinical Epidemiology and Biometry
| | - Patricia Wagner
- Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Isabel Bröhl
- Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Ramsia Geisler
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Frankfurt am Main, Germany
- Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jörg J Vehreschild
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Frankfurt am Main, Germany
- Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Sabine Blaschke
- Emergency Department, University Medical Center Goettingen, Germany
| | - Carla Bellinghausen
- Goethe University Frankfurt, University Hospital Frankfurt, Medical Clinic I, Department of Respiratory Medicine / Allergology
| | - Milena Milovanovic
- Malteser Krankenhaus St. Franziskus Hospital, Medical Clinic I, Flensburg, Germany
| | - Dagmar Krefting
- Department of Medical Informatics, University Medical Center Göttingen, Germany
- Campus Institute Data Science, Georg-August-University, Göttingen, Germany
- German Center for Cardiovascular Research, Partner Site Göttingen, Germany
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8
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Appel KS, Maier D, Hopff SM, Mitrov L, Stecher M, Scherer M, Geisler R, Hagen M, Haas K, Reese JP, Jiru-Hillmann S, Miljukov O, Jakob CEM, Nunes de Miranda SM, Meybohm P, Hanß S, Erber J, Winter C, Tebbe JJ, Stellbrink C, Khodamoradi Y, Schmidt J, Hanses F, Scheer C, Blaschke S, Göpel S, Kluge S, Witzke O, Römmele C, Krawczyk M, Teufel A, Schmid J, Pape D, Schütte C, Tausche K, Milovanovic M, Krug N, Tepasse PR, Verket M, Hamprecht A, Tasci S, Hower M, Jensen BEO, Sprinzl MF, Zimmermann T, Vehreschild JJ. 1886. External Validation of the 4C Mortality Score and the qSOFA for Different Variants of Concerns of SARS-CoV-2 Using Data of the NAPKON Cross-Sectoral Cohort Platform (SUEP). Open Forum Infect Dis 2022. [PMCID: PMC9752978 DOI: 10.1093/ofid/ofac492.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Numerous predictive clinical scores with varying discriminatory performance have been developed in the context of the current coronavirus disease 2019 (COVID-19) pandemic. To support clinical application, we test the transferability of the frequently applied 4C mortality score (4C score) to the German prospective Cross-Sectoral Platform (SUEP) of the National Pandemic Cohort Network (NAPKON) compared to the non COVID-19 specific quick sequential organ failure assessment score (qSOFA). Our project aims to externally validate these two scores, stratified for the most prevalent variants of concerns (VOCs) of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in Germany. Methods A total of 685 adults with polymerase chain reaction (PCR)-detected SARS-CoV-2 infection were included from NAPKON-SUEP. Patients were recruited from 11/2020 to 03/2022 at 34 university and non-university hospitals across Germany. Missing values were complemented using multiple imputation. Predictive performance for in-hospital mortality at day of baseline visit was determined by area under the curve (AUC) with 95%-confidence interval (CI) stratified by VOCs of SARS-CoV-2 (alpha, delta, omicron) (Figure 1).
Study flow chart with inclusion criteria and methodological workflow. ![]() Results Preliminary results suggest a high predictive performance of the 4C score for in-hospital mortality (Table 1). This applies for the overall cohort (AUC 0.813 (95%CI 0.738-0.888)) as well as the VOC-strata (alpha: AUC 0.859 (95%CI 0.748-0.970); delta: AUC 0.769 (95%CI 0.657-0.882); omicron: AUC 0.866 (95%CI 0.724-1.000)). The overall mortality rates across the defined 4C score risk groups are 0.3% (low), 3.2% (intermediate), 11.6% (high), and 49.5% (very high). The 4C score performs significantly better than the qSOFA (Chi2-test: p=0.001) and the qSOFA does not seem to be a suitable tool in this context.
Discriminatory performance of the 4C Mortality Score and the qSOFA score within the validation cohort NAPKON-SUEP stratified by the Variant of Concerns of SARS-CoV-2. ![]() Conclusion Despite its development in the early phase of the pandemic and improved treatment, external validation of the 4C score in NAPKON-SUEP indicates a high predictive performance for in-hospital mortality across all VOCs. However, since the qSOFA was not specifically designed for this predictive issue, it shows low discriminatory performance, as in other validation studies. Any interpretations regarding the omicron stratum are limited due to the sample size. Disclosures Daniel Pape, Dr., Advanz Pharma Germany: Support for attending meetings and/or travel for ECCMID 2021 Martin Hower, n/a, MSD: Advisor/Consultant|Trogarzo: Advisor/Consultant|ViiV Healthcare: Advisor/Consultant Björn-Erik O. Jensen, Dr. med., GILEAD: Advisor/Consultant|GILEAD: Lectures, Travel|GSK: Lectures, Travel Jörg J. Vehreschild, Univ.-Prof. Dr. med., Ärztekammer Nordrhein: Honoraria|Academy for Infectious Medicine, University Manchester: Honoraria|Astellas Pharma: Grant/Research Support|Astellas Pharma: Honoraria|Back Bay Strategies: Honoraria|Basilea: Grant/Research Support|Basilea: Honoraria|Deutsches Zetrum für Luft- und Raumfahrt (DLR): Grant/Research Support|German Centre for Infection Research (DZIF): Grant/Research Support|German Centre for Infection Research (DZIF): Honoraria|German Federal Ministry of Education and Research (BMBF): Grant/Research Support|German Society for Infectious Diseases (DGI): Honoraria|German Society for Internal Medicine (DGIM): Honoraria|GILEAD: Advisor/Consultant|GILEAD: Grant/Research Support|GILEAD: Honoraria|Janssen: Honoraria|Merck / MSD: Grant/Research Support|Merck / MSD: Honoraria|Molecular Health: Honoraria|Netzwerk Universitätsmedizin: Honoraria|NordForsk: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Rigshospitalet Copenhagen: Grant/Research Support|Shionogi: Advisor/Consultant|Shionogi: Honoraria|University Hospital Aachen: Honoraria|University Hospital Freiburg/ Congress and Communication: Honoraria|University of Bristol: Grant/Research Support.
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Affiliation(s)
- Katharina S Appel
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany, Frankfurt am Main, Hessen, Germany
| | - Daniel Maier
- University Hospital Frankfurt, Frankfurt am Main, Germany,German Cancer Consortium (DKTK), Heidelberg, Germany, Frankfurt am Main, Hessen, Germany
| | - Sina M Hopff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Köln, Nordrhein-Westfalen, Germany
| | - Lazar Mitrov
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Köln, Nordrhein-Westfalen, Germany
| | - Melanie Stecher
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany, Cologne, Nordrhein-Westfalen, Germany
| | - Margarete Scherer
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany, Frankfurt am Main, Hessen, Germany
| | - Ramsia Geisler
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany, Frankfurt am Main, Hessen, Germany
| | - Marina Hagen
- Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany, Frankfurt am Main, Hessen, Germany
| | - Kirsten Haas
- Insitute for Clinical Epidemiology and Biometry, Julius Maximilians Universität Würzburg, Würzburg, Bayern, Germany
| | - Jens-Peter Reese
- Insitute for Clinical Epidemiology and Biometry, Julius Maximilians Universität Würzburg, Würzburg, Bayern, Germany
| | - Steffi Jiru-Hillmann
- Insitute for Clinical Epidemiology and Biometry, Julius Maximilians Universität Würzburg, Würzburg, Bayern, Germany
| | - Olga Miljukov
- Insitute for Clinical Epidemiology and Biometry, Julius Maximilians Universität Würzburg, Würzburg, Bayern, Germany
| | - Carolin E M Jakob
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany, Cologne, Nordrhein-Westfalen, Germany
| | - Susana M Nunes de Miranda
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Köln, Nordrhein-Westfalen, Germany
| | - Patrick Meybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Würzburg, Bayern, Germany
| | - Sabine Hanß
- University Medical Center Göttingen, Department of Medical Informatics, Göttingen, Germany, Göttingen, Niedersachsen, Germany
| | - Johanna Erber
- Technical University of Munich, School of Medicine – University Hospital, Department of Internal Medicine, Gastroenterology, Munich, Bayern, Germany
| | - Christof Winter
- Technical University of Munich, School of Medicine – University Hospital, Institute for Clinical Chemistry and Pathobiochemistry, Munich, Bayern, Germany
| | - Johannes J Tebbe
- University Medical Center East Westphalia-Lippe, Klinikum Lippe, Department of Gastroenterology and Infectious Disease, Lippe, Nordrhein-Westfalen, Germany
| | - Christoph Stellbrink
- Bielefeld University, Medical School and University Medical Center East Westphalia-Lippe, Klinikum Bielefeld, Academic Department of Cardiology, Bielefeld, Nordrhein-Westfalen, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt am Main, Germany, Frankfurt am Main, Hessen, Germany
| | - Julia Schmidt
- Insitute for Clinical Epidemiology and Biometry, Julius Maximilians Universität Würzburg, Würzburg, Bayern, Germany
| | - Frank Hanses
- Emergency Department and Department for Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany, Regensburg, Bayern, Germany
| | - Christian Scheer
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Sabine Blaschke
- Emergency Department, University Medical Center Göttingen, FRG, Göttingen, Niedersachsen, Germany
| | - Siri Göpel
- Department of Internal Medicine I, Infectious Diseases, Tübingen University Hospital, Tübingen, Germany,German Centre for Infection Research (DZIF), Clinical Research Unit for healthcare associated infections, Tübingen, Germany, Tübingen, Baden-Wurttemberg, Germany
| | - Stefan Kluge
- Department of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitymedicine Essen, University Duisburg-Essen, Germany, Essen, Nordrhein-Westfalen, Germany
| | - Christoph Römmele
- Clinic for Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Augsburg, Germany, Augsburg, Bayern, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany, Homburg, Saarland, Germany
| | - Andreas Teufel
- Department of Medicine II, Division of Hepatology, Division of Bioinformatics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,Clinical Cooperation Unit Healthy Metabolism, Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, Mannheim, Baden-Wurttemberg, Germany
| | - Jonas Schmid
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, Medicine I, Erlangen, Germany, Erlangen, Bayern, Germany
| | - Daniel Pape
- Department of Internal Medicine I, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
| | - Christian Schütte
- Dept. of Medicine I, St. Josef-Hospital, Ruhr-University of Bochum Medical School, Bochum, Nordrhein-Westfalen, Germany
| | - Kristin Tausche
- Department of Internal Medicine I, Pulmonology, Carl- Gustav-Carus University Dresden, Germany, Dresden, Sachsen, Germany
| | - Milena Milovanovic
- Medical Clinic 1, Malteser Krankenhaus St. Franziskus Hospital, Flensburg, Germany, Flensburg, Schleswig-Holstein, Germany
| | - Natalie Krug
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, Germany, Leipzig, Sachsen, Germany
| | - Phil-Robin Tepasse
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology, Clinical Infectiology, Münster, Germany, Münster, Nordrhein-Westfalen, Germany
| | - Marlo Verket
- Department of Medicine I, Clinical Study Center, University Hospital Aachen, Aachen, Nordrhein-Westfalen, Germany
| | - Axel Hamprecht
- University Medical Clinic of Medical Microbiology and Virology, Department of Human Medicine, University Oldenburg, Germany, Oldenburg, Niedersachsen, Germany
| | - Selcuk Tasci
- Department of Pulmonology, Helios Klinikum, Siegburg, Germany, Siegburg, Nordrhein-Westfalen, Germany
| | - Martin Hower
- Department of Pneumology, Infectiology, Internal Medicine and Intensive Care, Klinikum Dortmund GmbH, Dortmund, Dortmund, Nordrhein-Westfalen, Germany
| | - Björn-Erik O Jensen
- Department of Gastroenterology, Hepatology and Infectiology, Heinrich-Heine-University, Duesseldorf, Germany, Düsseldorf, Nordrhein-Westfalen, Germany
| | - Martin F Sprinzl
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany, Mainz, Rheinland-Pfalz, Germany
| | - Tim Zimmermann
- Department of Internal Medicine II, Gastroenterology and Hepatology, Klinikum Worms, Germany, Worms, Rheinland-Pfalz, Germany
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9
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Stephan B, Girbig G, Scherer M, Blozik E, Augustin M. [Dermatological video consultations for German prisons : Experiences from teledermatological consultations 2020 to 2022]. Dermatologie (Heidelb) 2022; 73:859-865. [PMID: 36149473 DOI: 10.1007/s00105-022-05060-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND With increasing shortage of medical personnel also in the medical care in German correctional facilities, telemedicine has been used since 2016, initially in projects and then for regular medical care. Since 2019, there is the possibility of dermatological expertise in regular video consultations. OBJECTIVE The benefits of an interdisciplinary online consultation with video and store and forward technology for dermatological issues are highlighted in terms of efficiency and feasibility. MATERIAL AND METHODS A descriptive analysis of 450 dermatological video consultations for German correctional facilities from February 2020 to July 2022 was carried out with respect to procedures, indications and demand. RESULTS Requests were made via a standardised form with optional photographs, which were sent via a secure cloud to the dermatology department in store and forward mode. The majority of cases could be presented live in a regular weekly video consultation and only single cases required an acute presentation within 24 h. The spectrum of skin diseases was comparable to cases presenting to a dermatology outpatient clinic. The interdisciplinary consultation management together with colleagues from general medicine enabled the transfer of the cases to the medical personnel at the correctional facility on site for follow-up and further medical procedures. Treatment could be started in all cases without delay. CONCLUSION Teledermatology represents an important contribution to medical care in German correctional facilities and the interdisciplinary cooperation saves time and resources in the presentation and treatment of skin diseases.
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Affiliation(s)
- B Stephan
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - G Girbig
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - M Scherer
- A+ Videoclinic GmbH, München, Deutschland
- Institut und Poliklinik für Allgemeinmedizin (IPA), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - E Blozik
- A+ Videoclinic GmbH, München, Deutschland
- Institut für Hausarztmedizin, Universitätsspital Zürich (USZ), Zürich, Schweiz
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
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10
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Lindemann C, Busch S, Bott T, Meusch A, Loewe B, Scherer M, von dem Knesebeck O, Haerter M. The development of a regional network for health care research in Hamburg, Germany. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
At the University Medical Center Hamburg-Eppendorf (UKE), health care research has been established as one of five research priorities recommended by the Research Council with the founding of the Center for Health Care Research (CHCR) in 2006. The CHCR was involved in numerous research projects with the focus on strengthening regional networking. Despite the numerous initiatives, there is still potential for improvement with regard to a systematic and sustainable exchange in the region of Hamburg, Germany.
Methods
These requirements led to the initiation of the ‘Hamburg Network Health Services Research (HAM-NET)'. The mission of HAM-NET is to build an open forum for all relevant institutions, to concentrate their interests and needs in health services research and to promote and conduct innovative, efficient, needs-based and patient-centred health services research projects in the metropolitan area of Hamburg. Three main tasks were appointed: 1) linking health care research to relevant regional institutions, 2) promoting research activities and new fields of research and 3) using methodological expertise to promote young scientists.
Results
By today 40 institutions from all sectors of health care joined HAM-NET. The regularly general meetings offer exchange and advice. Internal communication is promoted by mailing lists and newsletters. Also, HAM-NET presents itself with a website, logo and by organizing recurring events and participating in international and national congresses and networks. Within two funding phases a total of four overarching research projects were developed and implemented. Furthermore, a person with lived experience committee was established.
Conclusions
For the further development of health care research as one the core disciplines of public health a regional network with an efficient infrastructure is needed. HAM-NET promotes this with the implementation of an innovative, efficient and patient-oriented network.
Key messages
• Regional networks help to integrate multiple public health initiatives and community stakeholders.
• Public health networks can be established on multidisciplinary cooperations in different out- and inpatient sector levels.
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Affiliation(s)
- C Lindemann
- University Medical Center Hamburg-Eppendorf, Centre for Health Care Research , Hamburg, Germany
| | - S Busch
- University of Applied Sciences, Competence Center Gesundheit , Hamburg, Germany
| | - T Bott
- AOK Rheinland/Hamburg , Hamburg, Germany
| | | | - B Loewe
- University Medical Center Hamburg-Eppendorf, Department of Psychosomatic Medicine and Psychotherapy , Hamburg, Germany
| | - M Scherer
- University Medical Center Hamburg-Eppendorf, Department of General Practice and Primary Care , Hamburg, Germany
| | - O von dem Knesebeck
- University Medical Center Hamburg-Eppendorf, Institute of Medical Sociology , Hamburg, Germany
| | - M Haerter
- University Medical Center Hamburg-Eppendorf, Institute and Outpatients Clinic of Medical Psychology , Hamburg, Germany
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11
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Welzel FD, Pentzek M, Bickel H, Weyerer S, Wiese B, König HH, Maier W, Scherer M, Wagner M, Riedel-Heller SG. Inzidenz von Angstsymptomen und assoziierte Risikofaktoren im hohen
Lebensalter – Ergebnisse der
AgeCoDe/AgeQualiDe-Studie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- FD Welzel
- Universität Leipzig, Institut für Sozialmedizin,
Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
| | - M Pentzek
- Heinrich-Heine-Universität Düsseldorf, Institut
für Allgemeinmedizin, Düsseldorf, Deutschland
| | - H Bickel
- Technische Universität München, Klinik für
Psychiatrie und Psychotherapie, München, Deutschland
| | - S Weyerer
- Zentralinstitut für Seelische Gesundheit, Mannheim,
Deutschland
| | - B Wiese
- Medizinische Hochschule Hannover, Institut für
Allgemeinmedizin, Arbeitsgruppe Medizinische Statistik und IT-Infrastruktur,
Hannover, Deutschland
| | - H-H König
- Universitätsklinikum Hamburg-Eppendorf, Zentrum für
Psychosoziale Medizin, Institut für Gesundheitsökonomie und
Versorgungsforschung, Hamburg, Deutschland
| | - W Maier
- Universitätsklinikum Bonn, Klinik für Neurodegenerative
Erkrankungen und Gerontopsychiatrie, Bonn, Deutschland
| | - M Scherer
- Universitätsklinikum Hamburg-Eppendorf, Institut für
Allgemeinmedizin, Zentrum für Psychosoziale Medizin, Hamburg,
Deutschland
| | - M Wagner
- Universitätsklinikum Bonn, Klinik für Neurodegenerative
Erkrankungen und Gerontopsychiatrie, Bonn, Deutschland
- Deutsches Zentrum für Neurodegenerative Erkrankungen der
Helmholtz Gesellschaft, Bonn, Deutschland
| | - SG Riedel-Heller
- Universität Leipzig, Institut für Sozialmedizin,
Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
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12
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Klein J, Koens S, Strauß A, Scherer M, Härter M, von dem Knesebeck O. Einstellungen zur Notaufnahme in Krankenhäusern –
Eine Querschnittsbefragung der Hamburger
Allgemeinbevölkerung. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- J Klein
- Universitätsklinikum Hamburg-Eppendorf (UKE), Institut
für Medizinische Soziologie, Hamburg, Deutschland
| | - S Koens
- Universitätsklinikum Hamburg-Eppendorf (UKE), Institut
für Medizinische Soziologie, Hamburg, Deutschland
| | - A Strauß
- Universitätsklinikum Hamburg-Eppendorf (UKE), Institut
für Allgemeinmedizin, Hamburg, Deutschland
| | - M Scherer
- Universitätsklinikum Hamburg-Eppendorf (UKE), Institut
für Allgemeinmedizin, Hamburg, Deutschland
| | - M Härter
- Universitätsklinikum Hamburg-Eppendorf (UKE), Institut
für Medizinische Psychologie, Hamburg, Deutschland
| | - O von dem Knesebeck
- Universitätsklinikum Hamburg-Eppendorf (UKE), Institut
für Medizinische Soziologie, Hamburg, Deutschland
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13
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Schons M, Pilgram L, Reese JP, Stecher M, Anton G, Appel KS, Bahmer T, Bartschke A, Bellinghausen C, Bernemann I, Brechtel M, Brinkmann F, Brünn C, Dhillon C, Fiessler C, Geisler R, Hamelmann E, Hansch S, Hanses F, Hanß S, Herold S, Heyder R, Hofmann AL, Hopff SM, Horn A, Jakob C, Jiru-Hillmann S, Keil T, Khodamoradi Y, Kohls M, Kraus M, Krefting D, Kunze S, Kurth F, Lieb W, Lippert LJ, Lorbeer R, Lorenz-Depiereux B, Maetzler C, Miljukov O, Nauck M, Pape D, Püntmann V, Reinke L, Römmele C, Rudolph S, Sass J, Schäfer C, Schaller J, Schattschneider M, Scheer C, Scherer M, Schmidt S, Schmidt J, Seibel K, Stahl D, Steinbeis F, Störk S, Tauchert M, Tebbe JJ, Thibeault C, Toepfner N, Ungethüm K, Vadasz I, Valentin H, Wiedmann S, Zoller T, Nagel E, Krawczak M, von Kalle C, Illig T, Schreiber S, Witzenrath M, Heuschmann P, Vehreschild JJ. The German National Pandemic Cohort Network (NAPKON): rationale, study design and baseline characteristics. Eur J Epidemiol 2022; 37:849-870. [PMID: 35904671 PMCID: PMC9336157 DOI: 10.1007/s10654-022-00896-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
Abstract
The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON’s goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36–62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON’s design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities. Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04768998.https://clinicaltrials.gov/ct2/show/NCT04747366.https://clinicaltrials.gov/ct2/show/NCT04679584
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Affiliation(s)
- Maximilian Schons
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pilgram
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Jens-Peter Reese
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany
| | - Gabriele Anton
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Katharina S. Appel
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Thomas Bahmer
- Internal Medicine Department I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Alexander Bartschke
- Core Facility Digital Medicine and Interoperability, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Carla Bellinghausen
- Department of Respiratory Medicine and Allergology, Medical Clinic 1, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Inga Bernemann
- Hannover Medical School, Hannover Unified Biobank, Hannover, Germany
| | - Markus Brechtel
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Folke Brinkmann
- Department of Paediatric Pneumology, Allergy and CF- Centre, University Children’s Hospital, Ruhr- University Bochum, Bochum, Germany
| | - Clara Brünn
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christine Dhillon
- COVID-19 Task Force, University Hospital Augsburg, Augsburg, Germany
| | - Cornelia Fiessler
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Ramsia Geisler
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Eckard Hamelmann
- Department of Pediatrics, Children’s Center Bethel, University Hospital East Westphalia, University Bielefeld, Bielefeld, Germany
| | - Stefan Hansch
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
| | - Frank Hanses
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
| | - Sabine Hanß
- University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
| | - Susanne Herold
- Department of Internal Medicine V, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany
- Department of Internal Medicine, German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Justus Liebig University Giessen, Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
| | - Ralf Heyder
- NUM Coordination Office, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Anna-Lena Hofmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Sina Marie Hopff
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anna Horn
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Carolin Jakob
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Steffi Jiru-Hillmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Keil
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Yascha Khodamoradi
- Department of Infectious Diseases, Medical Clinic 2, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Mirjam Kohls
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Monika Kraus
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
| | - Dagmar Krefting
- University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
| | - Sonja Kunze
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, and Department of Medicine I, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Lena Johanna Lippert
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU, Munich, Germany
- Medical Heart Center of Charité and German Heart Institute Berlin, Institute of Computer-Assisted Cardiovascular Medicine, Berlin, Germany
| | - Bettina Lorenz-Depiereux
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
| | - Corina Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Olga Miljukov
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Daniel Pape
- Department I of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Valentina Püntmann
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt am Main, Frankfurt, Germany
| | - Lennart Reinke
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christoph Römmele
- COVID-19 Task Force, University Hospital Augsburg, Augsburg, Germany
| | - Stefanie Rudolph
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin, Joint Charité and BIH Clinical Study Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Julian Sass
- Core Facility Digital Medicine and Interoperability, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Schäfer
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK e.V. (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Jens Schaller
- Medical Heart Center of Charité and German Heart Institute Berlin, Institute of Computer-Assisted Cardiovascular Medicine, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt – Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Mario Schattschneider
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christian Scheer
- Department of Anesthesiology and Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Margarete Scherer
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Sein Schmidt
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Clinical Study Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Julia Schmidt
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Kristina Seibel
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dana Stahl
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- University Medicine Greifswald, Greifswald, Germany
| | - Fridolin Steinbeis
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Maike Tauchert
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
| | - Johannes Josef Tebbe
- Department of Gastroenterology and Infectious Disease, University Medical Center East Westphalia-Lippe, Klinikum Lippe, Detmold, Germany
| | - Charlotte Thibeault
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Carl Gustav Carus University Hospital, TU Dresden, Dresden, Germany
| | - Kathrin Ungethüm
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Istvan Vadasz
- Institute for Lung Health (ILH), Giessen, Germany
- Department of Internal Medicine, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Frankfurt, Germany
| | - Heike Valentin
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- University Medicine Greifswald, Greifswald, Germany
| | - Silke Wiedmann
- NUM Coordination Office, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Zoller
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Eike Nagel
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt am Main, Frankfurt, Germany
| | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christof von Kalle
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin, Joint Charité and BIH Clinical Study Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Illig
- Hannover Medical School, Hannover Unified Biobank, Hannover, Germany
| | - Stefan Schreiber
- Department of Internal Medicine I, University Hospital Schleswig Holstein, Kiel University, Kiel, Germany
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- German Center for Lung Research (DZL), Frankfurt, Germany
| | - Peter Heuschmann
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt,, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
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Kozmik T, Deschka H, Martens S, Scherer M, Rukosujew A, Goldstein F, Hoffmeier A. Early Results of Minimally Invasive Mitral Valve Repair through Upper Partial Sternotomy, 8 Years’ Single-Center Experience. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T. Kozmik
- Universitätsklinikum Münster - UKM, Münster, Deutschland
| | - H. Deschka
- Albert-Schweitzer-Campus 1, Münster, Deutschland
| | - S. Martens
- Albert-Schweitzer-Campus 1, Münster, Deutschland
| | - M. Scherer
- University Hospital Muenster, Münster, Deutschland
| | - A. Rukosujew
- Universitätsklinik Münster - Klinik für Herzchirurgie Münster, Münster, Deutschland
| | - F. Goldstein
- University Hospital Münster - UKM, Münster, Deutschland
| | - A. Hoffmeier
- Klinik für Herzchirurgie Münster, Münster, Deutschland
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15
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Förster F, Luppa M, Pabst A, Löbner M, Scherer M, Wagner M, Riedel-Heller SG. The role of social isolation in the relationship between widowhood and depressive symptomatology. A comparison among the widowed and married oldest old in Germany. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F Förster
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - M Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - A Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - M Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - M Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf
| | - M Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn
- German Center for Neurodegenerative Diseases, DZNE
| | - SG Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
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16
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Hajek A, Buczak-Stec E, Bickel H, Wiese B, Weyerer S, Pentzek M, Wagner M, Maier W, Scherer M, Riedel-Heller SG, König HH. Determinanten der Institutionalisierung im Zeitverlauf. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Hajek
- Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung
| | - E Buczak-Stec
- Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung
| | - H Bickel
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München
| | - B Wiese
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover
| | - S Weyerer
- Mannheim/Universität Heidelberg, Zentralinstitut für Seelische Gesundheit
| | - M Pentzek
- Heinrich-Heine-Universität Düsseldorf, Institut für Allgemeinmedizin
| | - M Wagner
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Psychiatrie/Psychotherapie
| | - W Maier
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Psychiatrie/Psychotherapie
| | - M Scherer
- Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin
| | - SG Riedel-Heller
- Universität Leipzig, Institut für Sozialmedizin, Arbeitsmedizin und Public Health
| | - HH König
- Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung
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17
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Luppa M, Pabst A, Löbner M, Maier A, Durrant-Finn C, Wagner M, Scherer M, SG RH. Incidence and Predictors of Depression in Late Life. Results from the AgeCoDe-/AqeQualiDe study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Faculty of Medicine
| | - A Pabst
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Faculty of Medicine
| | - M Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Faculty of Medicine
| | - A Maier
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Faculty of Medicine
| | - C Durrant-Finn
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Faculty of Medicine
| | - M Wagner
- German Center for Neurodegenerative Diseases, DZNE
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn
| | - M Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf
| | - Riedel-Heller SG
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Faculty of Medicine
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18
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Hohls JK, König HH, Eisele M, Mallon T, Mamone S, Wiese B, Weyerer S, Fuchs A, Pentzek M, Röhr S, Welzel F, Mösch E, Weeg D, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, Hajek A. Hilfesuche aufgrund von psychischen Belastungen im hohen Alter und die Rolle von erhöhter Angstsymptomatik – Ergebnisse der AgeQualiDe-Studie. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- JK Hohls
- Institut für Gesundheitsökonomie & Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf
| | - H-H König
- Institut für Gesundheitsökonomie & Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf
| | - M Eisele
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - T Mallon
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - S Mamone
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover
| | - B Wiese
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover
| | - S Weyerer
- Zentralinstitut für Seelische Gesundheit
| | - A Fuchs
- Institut für Allgemeinmedizin, Heinrich-Heine-Universität Düsseldorf
| | - M Pentzek
- Institut für Allgemeinmedizin, Heinrich-Heine-Universität Düsseldorf
| | - S Röhr
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universitätsklinikum Leipzig
| | - F Welzel
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universitätsklinikum Leipzig
| | - E Mösch
- Klinikum für Psychiatrie und Psychotherapie, Technische Universität München
| | - D Weeg
- Klinikum für Psychiatrie und Psychotherapie, Technische Universität München
| | - K Heser
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn
| | - M Wagner
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
| | - M Scherer
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - W Maier
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universitätsklinikum Leipzig
| | - A Hajek
- Institut für Gesundheitsökonomie & Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf
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Grothe J, Röhr S, Luppa M, Scherer M, Weyerer S, König HH, Wagner M, Riedel-Heller SG. Social isolation and incident dementia in the oldest-old – A competing risk analysis. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J Grothe
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - S Röhr
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
- Global Brain Health Institute (GBHI), Trinity College Dublin
| | - M Luppa
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - M Scherer
- Institut und Poliklinik für Allgemeinmedizin, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
| | - S Weyerer
- Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim der Universität Heidelberg, Universität Heidelberg
| | - H-H König
- Institut für Gesundheitsökonomie und Versorgungsforschung, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
| | - M Wagner
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
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Kloppe T, Zimmermann T, Mews C, Tetzlaff B, Scherer M. Krank, arm, einsam und arbeitslos – Verbindung von hausärztlicher Praxis und sozialem Hilfesystem – ein Konzept für Aus- und Fortbildung. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Kloppe
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin
| | - T Zimmermann
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin
| | - C Mews
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin
| | - B Tetzlaff
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin
| | - M Scherer
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin
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Affiliation(s)
- S Kluge
- Zentrum für Anästhesiologie und Intensivmedizin, Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | | | - M Scherer
- Institut und Poliklinik für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Porz L, Knez D, Scherer M, Ganschow S, Kothleitner G, Rettenwander D. Dislocations in ceramic electrolytes for solid-state Li batteries. Sci Rep 2021; 11:8949. [PMID: 33903661 PMCID: PMC8076269 DOI: 10.1038/s41598-021-88370-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/06/2021] [Indexed: 11/18/2022] Open
Abstract
High power solid-state Li batteries (SSLB) are hindered by the formation of dendrite-like structures at high current rates. Hence, new design principles are needed to overcome this limitation. By introducing dislocations, we aim to tailor mechanical properties in order to withstand the mechanical stress leading to Li penetration and resulting in a short circuit by a crack-opening mechanism. Such defect engineering, furthermore, appears to enable whisker-like Li metal electrodes for high-rate Li plating. To reach these goals, the challenge of introducing dislocations into ceramic electrolytes needs to be addressed which requires to establish fundamental understanding of the mechanics of dislocations in the particular ceramics. Here we evaluate uniaxial deformation at elevated temperatures as one possible approach to introduce dislocations. By using hot-pressed pellets and single crystals grown by Czochralski method of Li6.4La3Zr1.4Ta0.6O12 garnets as a model system the plastic deformation by more than 10% is demonstrated. While conclusions on the predominating deformation mechanism remain challenging, analysis of activation energy, activation volume, diffusion creep, and the defect structure potentially point to a deformation mechanism involving dislocations. These parameters allow identification of a process window and are a key step on the road of making dislocations available as a design element for SSLB.
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Affiliation(s)
- L Porz
- FG Nichtmetallisch-Anorganische Werkstoffe, Department of Materials and Earth Sciences, Technical University of Darmstadt, Darmstadt, Germany.
| | - D Knez
- Graz Centre for Electron Microscopy, Graz, Austria
- Institute of Electron Microscopy and Nanoanalysis, NAWI Graz, Graz University of Technology, Graz, Austria
| | - M Scherer
- FG Nichtmetallisch-Anorganische Werkstoffe, Department of Materials and Earth Sciences, Technical University of Darmstadt, Darmstadt, Germany
| | - S Ganschow
- Leibniz-Institut für Kristallzüchtung (IKZ), Berlin, Germany
| | - G Kothleitner
- Graz Centre for Electron Microscopy, Graz, Austria
- Institute of Electron Microscopy and Nanoanalysis, NAWI Graz, Graz University of Technology, Graz, Austria
| | - D Rettenwander
- Department of Material Science and Engineering, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
- International Christian Doppler Laboratory for Solid-State Batteries, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
- Institute of Chemistry and Technology of Materials, NAWI Graz, Graz University of Technology, Graz, Austria.
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Schladitz K, Löbner M, Stein J, Weyerer S, Werle J, Wagner M, Heser K, Scherer M, Stark A, Kaduszkiewicz H, Wiese B, Oey A, König HH, Hajek A, Riedel-Heller SG. Grief and loss in old age: Exploration of the association between grief and depression. J Affect Disord 2021; 283:285-292. [PMID: 33578340 DOI: 10.1016/j.jad.2021.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/13/2021] [Accepted: 02/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The proportion of older adults is increasing due to demographic changes. Depression belongs to the most common mental disorders in late life. The loss of an emotionally significant person is a risk factor for the development of depression. The aim of this study is to analyze the association between depression and grief burden resulting from loss. Based on prior evidence, we examined loneliness as a possible mediator and social support as possible moderator of this association. METHODS The cross-sectional analyses are based on a sample (N = 863) of study participants aged 75+ (M = 81.4 years, SD = 4.4, 62.2% female) with loss experience deriving from the multicenter prospective German cohort study AgeMooDe. Regression analyses (moderated mediation) were performed. RESULTS With increasing age (β = 0.10, p = .005) and grief burden (β = 0.33, p <. 001) depression severity increased. There was an indirect mediating effect of loneliness on the correlation of grief burden and depression (b = 0.04, CI [0.03, 0.05]), but no moderating effect of social support on the correlation of grief burden and loneliness. People living alone had a significantly higher risk of depression, increased loneliness and lack of social support. LIMITATIONS Assessments were based on self-reporting and recorded dimensionally. The cross-sectional design limits conclusions about directions and causality of associations. Sampling bias cannot be completely excluded. CONCLUSION The study provides empirical evidence and a better understanding of the association between grief and depression among the very old and the mediating role of loneliness.
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Affiliation(s)
- K Schladitz
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany.
| | - M Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany
| | - J Stein
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany
| | - S Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Werle
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases within the Helmholtz Association, DZNE, Bonn, Germany
| | - K Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - M Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stark
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Kaduszkiewicz
- Institute of General Practice, Medical Faculty, University of Kiel, Kiel, Germany
| | - B Wiese
- Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - A Oey
- Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - H-H König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - A Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany
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Kozmik T, Dell'aquila AM, Wagner NM, Martens S, Scherer M, Rukosujew A, Hoffmeier A. Preliminary Results of Minimally Invasive Triple Valve Surgery through Upper Partial Sternotomy: A Nine-Year Single-Centre Experience. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Welp H, Dell'Aquila A, Hoffmeier A, Martens S, Scherer M. Medical and Economic Consideration Regarding Long Term Mechanical Left Ventricular Support. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Welp H, Dell'Aquila A, Hoffmeier A, Scherer M. Medical and Financial Considerations Regarding Long-Term Mechanical Left Ventricular Support. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Scherer M, Milosevic L, Guggenberger R, Volker M, Naros G, Grimm F, Bucurenciu I, Steinhoff B, Weber Y, Lerche H, Weiss D, Rona S, Gharabaghi A. FV 25 Cortical α-activity identifies responders to anterior thalamic deep brain stimulation for epilepsy. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Deschka H, Pogoda C, Martens S, Scherer M, Welp H. Long-Term Results of Calcineurin Inhibitor-Free Immunosuppression Using Everolimus after Heart Transplantation. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1679018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H. Deschka
- Universitätsklinikum Münster, Department für Herz- und Thoraxchirurgie; Klinik für Herzchiruirgie, Münster, Germany
| | - C. Pogoda
- Department of Cardiology, Universitätsklinikum Münster, Münster, Germany
| | - S. Martens
- Universitätsklinikum Münster, Department für Herz- und Thoraxchirurgie; Klinik für Herzchiruirgie, Münster, Germany
| | - M. Scherer
- Universitätsklinikum Münster, Department für Herz- und Thoraxchirurgie; Klinik für Herzchiruirgie, Münster, Germany
| | - H. Welp
- Universitätsklinikum Münster, Department für Herz- und Thoraxchirurgie; Klinik für Herzchiruirgie, Münster, Germany
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Deschka H, Schäfers B, Gottschalk A, Scherer M, Martens S, Welp H. The Effect of Different Cannulation Strategies for Extracorporeal Membrane Oxygenation Support in Postcardiotomy Patients. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H. Deschka
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster, Klinik für Herzchiruirgie, Münster, Germany
| | - B. Schäfers
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster, Klinik für Herzchiruirgie, Münster, Germany
| | - A. Gottschalk
- Department of Anästhesiology and Pain medicine, Universitätsklinikum Münster, Münster, Germany
| | - M. Scherer
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster, Klinik für Herzchiruirgie, Münster, Germany
| | - S. Martens
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster, Klinik für Herzchiruirgie, Münster, Germany
| | - H. Welp
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster, Klinik für Herzchiruirgie, Münster, Germany
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Deschka H, Schäfers B, Gottschalk A, Scherer M, Martens S, Welp H. Effects of Levosimendan Therapy in Patients Undergoing Extracorporeal Membrane Oxygenation after Cardiac Surgery. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1679012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H. Deschka
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster; Klinik für Herzchiruirgie, Münster, Germany
| | - B. Schäfers
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster; Klinik für Herzchiruirgie, Münster, Germany
| | - A. Gottschalk
- Department of Anästhesiology and Pain Medicine, Universitätsklinikum Münster, Münster, Germany
| | - M. Scherer
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster; Klinik für Herzchiruirgie, Münster, Germany
| | - S. Martens
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster; Klinik für Herzchiruirgie, Münster, Germany
| | - H. Welp
- Department für Herz- und Thoraxchirurgie, Universitätsklinikum Münster; Klinik für Herzchiruirgie, Münster, Germany
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Pohontsch NJ, Stark A, Ehrhardt M, Kötter T, Scherer M. Influences on students' empathy in medical education: an exploratory interview study with medical students in their third and last year. BMC Med Educ 2018; 18:231. [PMID: 30290824 PMCID: PMC6173872 DOI: 10.1186/s12909-018-1335-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 09/26/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Empathy is beneficial for patients and physicians. It facilitates treatment and improves physical and psychosocial outcomes. The therapeutic relevance of empathy emphasizes the need to help medical students develop their empathic abilities. Our study aimed to identify factors which promote or hinder the development and expression of empathy in medical students during the course of their studies. METHODS We interviewed 24 medical students (six male and six female students in their 6th semester as well as six male and six female students in their final clinical year) using semi-structured interviews. The interviews were recorded, transcribed verbatim and analyzed using Braun & Clarke's thematic analysis. RESULTS We identified four main themes influencing the development and expression of empathy. 1) Course of studies: hands-on-experience, role models, science and theory, and emphasis on the importance of empathy; 2) students: insecurities and lack of routine, increasing professionalism, previous work experiences, professional distance, mood, maturity, and personal level of empathy; 3) patients: "easy" and "difficult" patients including their state of health; and 4) surrounding conditions: time pressure/stress, work environment, and job dissatisfaction. CONCLUSIONS The development and use of empathy could be promoted by increasing: hands-on-experiences, possibilities to experience the patient's point of view and offering patient contact early in the curriculum. Students need support in reflecting on their actions, behavior and experiences with patients. Instructors need time and opportunities to reflect on their own communication with and treatment of patients, on their teaching behavior, and on their function as role models for treating patients empathically and preventing stress. Practical experiences should be made less stressful for students. The current changes implemented in some medical school curriculums (e.g., in Germany) seem to go in the right direction by integrating patient contact early on in the curriculum and focusing more on teaching adequate communication and interaction behaviors.
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Affiliation(s)
- N J Pohontsch
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stark
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Ehrhardt
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Kötter
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - M Scherer
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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32
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Jungk C, Scherer M, DaoTrong H, Schramm C, Haehnel S, Herold-Mende C, Unterberg A. P01.106 Impact of intraoperative magnetic resonance imaging on the extent of resection and functional outcome in awake surgery for eloquent gliomas - a single center retrospective study. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Jungk
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
- Division of Experimental Neurosurgery, Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M Scherer
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - H DaoTrong
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - C Schramm
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - S Haehnel
- Department of Neuroradiology, Clinic of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - C Herold-Mende
- Division of Experimental Neurosurgery, Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - A Unterberg
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
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33
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Schäfer I, Stark A, Hardt H, Lühmann D, Scherer M. Evaluationsmatrix für die Gesundheits- und Dienstleistungsregionen von morgen: Ergebnisse aus dem INDiGeR Arbeitspaket „summative Evaluation“. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- I Schäfer
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
| | - A Stark
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
| | - H Hardt
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
| | - D Lühmann
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
| | - M Scherer
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
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34
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Pohontsch NJ, Zimmermann T, Jonas C, Lehmann M, Löwe B, Scherer M. Coding of medically unexplained symptoms and somatoform disorders by general practitioners - an exploratory focus group study. BMC Fam Pract 2018; 19:129. [PMID: 30053834 PMCID: PMC6064152 DOI: 10.1186/s12875-018-0812-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/28/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Medically unexplained symptoms (MUS) and somatoform disorders are common in general practices, but there is evidence that general practitioners (GPs) rarely use these codes. Assuming that correct classification and coding of symptoms and diseases are important for adequate management and treatment, insights into these processes could reveal problematic areas and possible solutions. Our study aims at exploring general practitioners' views on coding and reasons for not coding MUS/somatoform disorders. METHODS We invited GPs to participate in six focus groups (N = 42). Patient vignettes and a semi-structured guideline were used by two moderators to facilitate the discussions. Recordings were transcribed verbatim. Two researchers analyzed the data using structuring content analysis with deductive and inductive category building. RESULTS Three main categories turned out to be most relevant. For category a) "benefits of coding" GPs described that coding is seen as being done for reimbursement purposes and is not necessarily linked to the content of their reference files for a specific patient. Others reported to code specific diagnoses only if longer consultations to explore psychosomatic symptoms or psychotherapy are intended to be billed. Reasons for b) "restrained coding" were attempting to protect the patient from stigma through certain diagnoses and the preference for tentative diagnoses and functional coding. Some GPs admitted to c) "code inaccurately" attributing this to insufficient knowledge of ICD-10-criteria, time constraints or using "rules of thumb" for coding. CONCLUSIONS There seem to be challenges in the process of coding of MUS and somatoform disorders, but GPs appear not to contest the patients' suffering and accept uncertainty (about diagnoses) as an elementary part of their work. From GPs' points of view ICD-10-coding does not appear to be a necessary requirement for treating patients and coding might be avoided to protect the patients from stigma and other negative consequences. Our findings supply a possible explanation for the commonly seen difference between routine and epidemiological data. The recent developments in the DSM-5 and the upcoming ICD-11 will supposedly change acceptance and handling of these diagnoses for GPs and patients. Either way, consequences for GPs' diagnosing and coding behavior are not yet foreseeable.
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Affiliation(s)
- N. J. Pohontsch
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - T. Zimmermann
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - C. Jonas
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Clinic Hamburg Eilbek, Martinistr. 52, 20246 Hamburg, Germany
| | - M. Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Clinic Hamburg Eilbek, Martinistr. 52, 20246 Hamburg, Germany
| | - B. Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Clinic Hamburg Eilbek, Martinistr. 52, 20246 Hamburg, Germany
| | - M. Scherer
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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35
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Brettschneider C, Hajek A, Stein J, Luck T, Mamone S, Wiese B, Mösch E, Weeg D, Fuchs A, Pentzek M, Werle J, Weyerer S, Mallon T, van den Bussche H, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. [Informal care for dementia according to type of service]. Nervenarzt 2018; 89:509-515. [PMID: 29637234 DOI: 10.1007/s00115-018-0511-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Dementia is a major challenge for society and its impact will grow in the future. Informal care is an essential part of dementia care. Previous studies considered informal care as a whole and not by its components. OBJECTIVE We aimed to assess the degree of association between specific informal care services and dementia. MATERIAL AND METHODS This analysis is based on data from the seventh wave of the AgeCoDe/AgeQualiDe study. Dementia was diagnosed based on the DSM-IV criteria. Severity of dementia was assessed and categorized by means of the Clinical Dementia Rating and eight individual informal care services were considered. Logistic regression models were used to assess associations. RESULTS Of the 864 participants 18% suffered from dementia (very mild: 4%; mild: 6%; moderate: 5%; severe: 3%). All informal care services were significantly associated with dementia, with an emphasis on "supervision", "regulation of financial matters" and "assistance in the intake of medication". Considering different degrees of dementia severity, similar results arose from the analyses. All three aforementioned services showed a pronounced association with all degrees of dementia severity, except for supervision and very mild dementia. CONCLUSION The provision of all types of informal care services is associated with dementia. The association is pronounced for services that can be more easily integrated into the daily routines of the informal caregiver. Policy makers who plan to integrate informal care into the general care arrangements for dementia should consider this.
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Affiliation(s)
- C Brettschneider
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - A Hajek
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - J Stein
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Leipzig, Deutschland
| | - T Luck
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Leipzig, Deutschland
| | - S Mamone
- Institut für Allgemeinmedizin, AG Medizinische Statistik und IT-Infrastruktur, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - B Wiese
- Institut für Allgemeinmedizin, AG Medizinische Statistik und IT-Infrastruktur, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - E Mösch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - D Weeg
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - A Fuchs
- Institut für Allgemeinmedizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - M Pentzek
- Institut für Allgemeinmedizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - J Werle
- Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - S Weyerer
- Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - T Mallon
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - H van den Bussche
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - K Heser
- Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Deutschland
| | - M Wagner
- Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Deutschland
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Deutschland
| | - M Scherer
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - W Maier
- Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Deutschland
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Deutschland
| | - S G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Leipzig, Deutschland
| | - H-H König
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
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Steul K, Scherer M, Behm A, Heudorf U. „Wenn dann richtig“ – Ein Projekt des MRE-Netz Rhein-Main zum sorgsamen Umgang mit Antibiotka bei Harnwegsinfektionen. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1639268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Steul
- Gesundheitsamt Frankfurt am Main, Infektiologie und Hygiene, Frankfurt am Main, Germany
| | - M Scherer
- Gesundheitsamt Frankfurt am Main, MRE-Netz Rhein-Main, Frankfurt am Main, Germany
| | - A Behm
- Praxis Mainurologe, Frankfurt am Main, Germany
| | - U Heudorf
- Gesundheitsamt Frankfurt am Main, Infektiologie und Hygiene, Frankfurt am Main, Germany
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Welp H, Sidermann J, Martens S, Gottschalk A, Scherer M. Anticoagulation with Argatroban in Patients Undergoing Extracorporal Life Support System Therapy. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- H. Welp
- Department für Herz- und Thoraxchirurgie, Klinik für Herzchiruirgie, Universitätsklinikum Münster, Münster, Germany
| | - J. Sidermann
- Department für Herz- und Thoraxchirurgie, Klinik für Herzchiruirgie, Universitätsklinikum Münster, Münster, Germany
| | - S. Martens
- Department für Herz- und Thoraxchirurgie, Klinik für Herzchiruirgie, Universitätsklinikum Münster, Münster, Germany
| | - A. Gottschalk
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - M. Scherer
- Department für Herz- und Thoraxchirurgie, Klinik für Herzchiruirgie, Universitätsklinikum Münster, Münster, Germany
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Hoffmeier A, Werner C, Sindermann J, Rukosujew A, Scherer M, Martens S, Welp H. Survival and Quality of Life after Cardiac Reoperations for Replacement of Infected Prosthetic Material. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Hoffmeier
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
| | - C. Werner
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
| | - J. Sindermann
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
| | - A. Rukosujew
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
| | - M. Scherer
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
| | - S. Martens
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
| | - H. Welp
- Department für Herz- und Thoraxchirurgie, UK Münster, Klinik für Herzchirurgie, Münster, Germany
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Dell'Aquila A, Motekallemi A, Welp H, Sindermann J, Scherer M. Performance of Simplified Acute Physiology Score (SAPS II Score) in Predicting Short- and Midterm Survival in Critically Ill Patients Prior to LVAD Implantation. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Dell'Aquila
- Klinik und Poliklinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - A. Motekallemi
- Klinik und Poliklinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - H. Welp
- Klinik und Poliklinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - J. Sindermann
- Klinik und Poliklinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - M. Scherer
- Klinik und Poliklinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsklinikum Münster, Münster, Germany
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40
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Hajek A, Brettschneider C, van den Bussche H, Kaduszkiewicz H, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Stein J, Luck T, Bickel H, Mösch E, Heser K, Bleckwenn M, Scherer M, Riedel-Heller SG, Maier W, König HH. Longitudinal Analysis of Outpatient Physician Visits in the Oldest Old: Results of the AgeQualiDe Prospective Cohort Study. J Nutr Health Aging 2018; 22:689-694. [PMID: 29806857 DOI: 10.1007/s12603-018-0997-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to identify determinants of outpatient health care utilization among the oldest old in Germany longitudinally. DESIGN Multicenter prospective cohort "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). SETTING Individuals in very old age were recruited via GP offices at six study centers in Germany. The course of outpatient health care was observed over 10 months (two waves). PARTICIPANTS Primary care patients aged 85 years and over (at baseline: n=861, with mean age of 89.0 years±2.9 years; 85-100 years). MEASUREMENTS Self-reported numbers of outpatient visits to general practitioners (GP) and specialists in the past three months were used as dependent variables. Widely used scales were used to quantify explanatory variables (e.g., Geriatric Depression Scale, Instrumental Activities of Daily Living Scale, or Global Deterioration Scale). RESULTS Fixed effects regressions showed that increases in GP visits were associated with increases in cognitive impairment, whereas they were not associated with changes in marital status, functional decline, increasing number of chronic conditions, increasing age, and changes in social network. Increases in specialist visits were not associated with changes in the explanatory variables. CONCLUSION Our findings underline the importance of cognitive impairment for GP visits. Creating strategies to postpone cognitive decline might be beneficial for the health care system.
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Affiliation(s)
- A Hajek
- Dr. André Hajek, University Medical Center, Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Telephone +49 40 7410 52877; Fax +49 40 7410 40261, E-Mail:
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Jacobs K, Leopold A, Hendricks DJ, Sampson E, Nardone A, Lopez KB, Rumrill P, Stauffer C, Elias E, Scherer M, Dembe J. Project Career: Perceived benefits of iPad apps among college students with Traumatic Brain Injury (TBI). Work 2017; 58:45-50. [PMID: 28922175 DOI: 10.3233/wor-172596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Project Career is an interprofessional five-year development project designed to improve academic and employment success of undergraduate students with a traumatic brain injury (TBI) at two- and four-year colleges and universities. Students receive technology in the form of iPad applications ("apps") to support them in and out of the classroom. OBJECTIVE To assess participants' perspectives on technology at baseline and perceived benefit of apps after 6 and 12 months of use. METHODS This article address a component of a larger study. Participants included 50 college-aged students with traumatic brain injuries. Statistical analysis included data from two Matching Person and Technology (MPT) assessment forms, including the Survey of Technology Use at baseline and the Assistive Technology Use Follow-Up Survey: Apps Currently Using, administered at 6- and 12-months re-evaluation. Analyses included frequencies and descriptives. RESULTS Average scores at baseline indicated positive perspectives on technology. At 6 months, quality of life (67%) and academics (76%) improved moderately or more from the use of iPad apps. At 12 months, quality of life (65%) and academics (82%) improved moderately or more from the use of iPad apps. CONCLUSION Students with a TBI have positive perspectives on technology use. The results on perceived benefit of apps indicated that students with a TBI (including civilians and veterans) report that the apps help them perform in daily life and academic settings.
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Affiliation(s)
- K Jacobs
- Boston University, Boston, MA, USA
| | - A Leopold
- JBS International, Inc., Bethesda, MD, USA
| | | | - E Sampson
- West Virginia University, Morgantown, WV, USA
| | | | - K B Lopez
- Kent State University, Kent, OH, USA
| | - P Rumrill
- Kent State University, Kent, OH, USA
| | | | - E Elias
- JBS International, Inc., Bethesda, MD, USA
| | - M Scherer
- University of Rochester, Rochester, NY, USA
| | - J Dembe
- Kent State University, Kent, OH, USA
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42
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Luck T, Riedel-Heller SG, Roehr S, Wiese B, Bickel H, Pentzek M, König HH, Scherer M, Maier W, Weyerer S. Mortality in incident cognitive impairment – Results of the prospective AgeCoDe study. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- T Luck
- University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig
| | - SG Riedel-Heller
- University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig
| | - S Roehr
- University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig
| | - B Wiese
- Hannover Medical School, Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover
| | - H Bickel
- Technical University of Munich, Department of Psychiatry, Klinikum rechts der Isar, Munich
| | - M Pentzek
- Heinrich-Heine-University Düsseldorf, Institute of General Practice, Medical Faculty, Düsseldorf
| | - HH König
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg
| | - M Scherer
- University Medical Center Hamburg-Eppendorf, Department of Primary Medical Care, Center for Psychosocial Medicine, Hamburg
| | - W Maier
- Department of Psychiatry, University of Bonn, Bonn
- DZNE, German Center for Neurodegenerative Diseases, Bonn
| | - S Weyerer
- Medical Faculty Mannheim/Heidelberg University, Central Institute of Mental Health, Mannheim
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Hansen H, Pohontsch NJ, Bole L, Schäfer I, Scherer M. Regional variations of perceived problems in ambulatory care from the perspective of general practitioners and their patients - an exploratory focus group study in urban and rural regions of northern Germany. BMC Fam Pract 2017; 18:68. [PMID: 28545402 PMCID: PMC5445300 DOI: 10.1186/s12875-017-0637-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/11/2017] [Indexed: 08/26/2023]
Abstract
BACKGROUND Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients. METHODS We conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany. Discussions were facilitated by two researchers using a semi-structured guideline. The transcripts were content analyzed using deductive and inductive categories. RESULTS General practitioners and patients reported problems due to demographic change and patient behaviour, through structural inequalities and the ambulatory reimbursement system as well as with specialist care and inpatient care. A high physician density, associated with high competition between general practitioners, a high fluctuation of patients and a low status of general practitioners were the main problems reported in urban areas. In contrast, participants from rural areas reported an insufficient physician density, a lack of young recruits in primary care and a resulting increased workload as problematic. All regions are concerned with subjectively inadequate general practitioners' budgets, insufficiently compensated consultations and problems in the cooperation with specialists and inpatient care institutions. Most problems were mentioned by GPs and patients alike, but some (e.g. high competition rates in urban regions and problems with inpatient care) were only mentioned by GPs. CONCLUSIONS While many problems arise in urban regions as well as in rural regions, our results support the notion that there is an urgent need for action in rural areas. Possible measures include the support of telemedicine, delegation of medical services and reoccupation of vacant practices. The attractiveness of working in rural areas for general practitioners, specialists and clinicians must be increased by consolidating and expanding rural infrastructure (e.g. child care and cultural life). The above mentioned results also indicate that the ambulatory reimbursement system should be examined regarding the reported inequalities. Measures to further enhance the cooperation between general practitioners, specialists and inpatient care should be taken to solve supra-regionally reported problems. Problems showing regional variations indicate the need for measures to balance these variations between the regions. This is the first German study to analyze subjective views of the stakeholders concerned on regionally variating problems in ambulatory care. Further studies are needed to quantify the extent of the identified problems and differences. A corresponding survey is currently under way.
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Affiliation(s)
- H Hansen
- Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N J Pohontsch
- Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - L Bole
- Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Schäfer
- Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Scherer
- Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Goessmann H, Dendl L, Pregler B, Wiggermann P, Scherer M, Opitz S, Niessen C, Fellner C, Stroszczynski C, Schreyer A. Natives Fast-MRI mit DWI zur radiologischen Evaluation einer Appendicitis. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- H Goessmann
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - L Dendl
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - B Pregler
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - P Wiggermann
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - M Scherer
- Universitaetsklinikum Regensburg, Klinik und Polyklinik für Chirugie, Regensburg
| | - S Opitz
- Universitaetsklinikum Regensburg, Klinik und Polyklinik für Chirugie, Regensburg
| | - C Niessen
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - C Fellner
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - C Stroszczynski
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - A Schreyer
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
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Welp H, Dell'Aquila A, Martens S, Sindermann J, Scherer M, Deschka H. Extracorporeal Membrane Oxygenation (ECMO) Support to Patients Aged 70 Years or More after Cardiac Surgery. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Welp
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - A. Dell'Aquila
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - S. Martens
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - J. Sindermann
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - M. Scherer
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - H. Deschka
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
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Welp H, Sindermann J, Martens S, Stelljes M, Scherer M. Bone Marrow Transplantation after Implantation of a Left Ventricular Assist Device. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Welp
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - J. Sindermann
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - S. Martens
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
| | - M. Stelljes
- Universitätsklinikum Münster, Medizinische Klinik A, Münster, Germany
| | - M. Scherer
- Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
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Dell'Aquila A, Avramovic N, Scherer M, Wenning C, Sindermann J. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Diagnosis of CF-LVAD Infections: A Single-Center Experience Including 61 Examinations. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A.M. Dell'Aquila
- Uniklinik Münster, Department für Thorax-, Herz- und Gefäßchirurgie, Münster, Germany
| | - N. Avramovic
- Uniklinik Münster, Department of Nuclear Medicine, Münster, Germany
| | - M. Scherer
- Uniklinik Münster, Department für Thorax-, Herz- und Gefäßchirurgie, Münster, Germany
| | - C. Wenning
- Uniklinik Münster, Department of Nuclear Medicine, Münster, Germany
| | - J.R. Sindermann
- Uniklinik Münster, Department für Thorax-, Herz- und Gefäßchirurgie, Münster, Germany
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48
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Hajek A, Brettschneider C, Lühmann D, Eisele M, Mamone S, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Luck T, Bickel H, Weeg D, Heser K, Jessen F, Maier W, Scherer M, Riedel-Heller SG, König HH. Does Visual Impairment Affect Social Ties in Late Life? Findings of a Multicenter Prospective Cohort Study in Germany. J Nutr Health Aging 2017; 21:692-698. [PMID: 28537334 DOI: 10.1007/s12603-016-0768-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate how visual impairment affects social ties in late life longitudinally. DESIGN Population-based prospective cohort study. SETTING Individuals in old age were recruited via general practitioners' offices (at six study centers) in Germany. They were interviewed every 18 months. PARTICIPANTS Individuals aged 75 years and above at baseline. Follow-up wave 2 (36 months after baseline, n=2,443) and wave 4 (72 months after baseline, n=1,618) were used for the analyses presented here. MEASUREMENTS Social ties were assessed using the 14-item form of the questionnaire for social support (F-SozU K-14). Visual impairment was self-rated on a three level Likert scale (no impairment, mild visual impairment, or severe/profound visual impairment). RESULTS Adjusting for sociodemographic factors, hearing impairment and comorbidity, fixed effects regressions revealed that the onset of mild visual impairment decreased the social support score, in particular the emotional support score. Additionally, the onset of mild hearing impairment decreased the social support score in men. Moreover, increasing age decreased the social support score in the total sample and in both sexes. Loss of spouse and increasing comorbidity did not affect the social support score. CONCLUSION Our results highlight the importance of visual impairment for social ties in late life. Consequently, appropriate strategies in order to delay visual impairment might help to maintain social ties in old age.
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Affiliation(s)
- A Hajek
- Dr. André Hajek, University Medical Center, Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Telephone +49 40 7410 52877; Fax +49 40 7410 40261, E-mail:
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49
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Alltag S, Stein J, Pabst A, Weyerer S, Maier W, Scherer M, Wiese B, König HH, Riedel-Heller SG. Unmet needs in the depressed primary care elderly and their relation to severity of depression: Results from the AgeMooDe study. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Hajek A, Brettschneider C, Ernst A, Posselt T, Mamone S, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Luck T, Bickel H, Mösch E, Kleineidam L, Heser K, Maier W, Scherer M, Riedel-Heller S, König HH. Einflussfaktoren auf die Pflegebedürftigkeit im Längsschnitt. Gesundheitswesen 2016; 79:73-79. [DOI: 10.1055/s-0041-111841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A. Hajek
- Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - C. Brettschneider
- Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - A. Ernst
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - T. Posselt
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - S. Mamone
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover
| | - B. Wiese
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover
| | - S. Weyerer
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Mannheim
| | - J. Werle
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Mannheim
| | - M. Pentzek
- Institut für Allgemeinmedizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - A. Fuchs
- Institut für Allgemeinmedizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - J. Stein
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig
| | - T. Luck
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig
| | - H. Bickel
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU München – Klinikum rechts der Isar, München
| | - E. Mösch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU München – Klinikum rechts der Isar, München
| | - L. Kleineidam
- Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | - K. Heser
- Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | - W. Maier
- Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | - M. Scherer
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - S. Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig
| | - H.-H. König
- Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg
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