scholarly journals Decreasing Number of Urodynamics in Urological and Gynaecological Clinics Reflects Decreased Importance for Surgical Indications: German Population-Based Data from 2013 to 2019

2021 ◽  
pp. 1-7
Author(s):  
Martin Baunacke ◽  
Isabel Leuchtweis ◽  
Albert Kaufmann ◽  
Marcel Schmidt ◽  
Christer Groeben ◽  
...  
Keyword(s):  
Population Based ◽  
Outpatient Setting ◽  
German Population ◽  
University Hospitals ◽  
Surgical Indications ◽  
Personnel Costs ◽  
Number Of Children ◽  
High Resource ◽  
Outpatient Sector ◽  
Quality Reports

<b><i>Introduction:</i></b> The routine use of urodynamic studies (UDS) has been questioned. Additionally, the material and personnel costs are poorly remunerated. We aimed to analyse the UDS utilization in Germany. <b><i>Methods:</i></b> We analysed UDS performed by hospitals based on quality reports from 2013 to 2019. A representative sample of 4 million insured persons was used to estimate outpatient UDS utilization from 2013 to 2018. <b><i>Results:</i></b> There was an overall decrease of 14% in UDS in Germany from 2013 to 2018 (60,980 to 52,319; <i>p</i> = 0.003). In the outpatient sector, there was a slight non-continuous drop of 11% from 34,551 to 30,652 from 2013 to 2018 (<i>p</i> = 0.06). UDS utilization in hospitals decreased by 26% from 26,429 in 2013 to 19,453 in 2019 (<i>p</i> = 0.004). University hospitals showed a smaller decrease (3,007 to 2,685; <i>p</i> = 0.02). In urology, the number of UDS (11,758 to 6,409; <i>p</i> &#x3c; 0.001) and the number of performing departments (328 to 263 clinics; <i>p</i> &#x3c; 0.001) decreased. Gynaecological departments also showed a decrease in UDS (1,861 to 866; <i>p</i> &#x3c; 0.001) and performing departments (159 to 68; <i>p</i> &#x3c; 0.001). However, in paediatrics, there was an increase in UDS (1,564 to 2,192; <i>p</i> = 0.02). By age, the number of children remained constant (1,371 to 1,252; <i>p</i> = 0.2), but there was a strong decrease seen in 60- to 79-year-olds (9,792 to 5,564; <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> UDS appear to be less important in the indication for surgery. Despite high resource expenditure and low remuneration, the decrease in urodynamics in the outpatient sector is less pronounced, indicating a trend to perform UDS in an outpatient setting.

Factor V Leiden and the risk of stillbirth in a German population

2003 ◽  
Vol 90 (09) ◽  
pp. 429-433 ◽  
Author(s):  
Rita Grimm ◽  
Daniel Robinson ◽  
Constanze Robinson ◽  
Thomas Kohlmann ◽  
Gudrun Schuster ◽  
...  
Keyword(s):  
Population Sample ◽  
Factor V Leiden ◽  
Population Based ◽  
German Population ◽  
Factor V ◽  
Factor V Leiden Mutation ◽  
Number Of Children ◽  
North East ◽  
Increased Risk ◽  
Affected Woman

SummaryAn association between the factor V Leiden variant and an increased risk of pregnancy loss has been reported. Most previous studies were performed with clinically recruited patients and controls. This approach may cause selection bias. The present analysis was performed with the aim to investigate the association between the factor V Leiden mutation and the risk of stillbirth in a population-based sample.The Study of Health in Pomerania (SHIP) is a survey that was carried out in North East Germany. A random sample from the population aged 20 to 79 years was taken. The total SHIP population comprised 4,310 participants. The presence of the factor V Leiden variant was determined by PCR and Mnl I digestion. The presence of the factor V Leiden variant was neither associated with the number of pregnancies nor with the number of children per women. Data from 1,768 females who had at least one pregnancy with known outcome was available for the present analysis. Seventy-three women (4.1%) reported at least one stillbirth. Women with and without the factor V Leiden mutation did not differ with respect to the number of women with at least one stillbirth (OR for factor V Leiden variant 1.57; 95%-CI 0.76 – 3.25). Furthermore, the number of women with two or more stillbirths, the number of stillbirths per affected woman and the number of stillbirths per number of pregnancies per woman was similar between both genotype groups.In conclusion, there is no association between the factor V Leiden mutation and the risk of stillbirth in a representative population sample.

Validation of the German Version of the Exercise Dependence Scale

2013 ◽  
Vol 29 (3) ◽  
pp. 213-219 ◽  
Author(s):  
Astrid Müller ◽  
Laurence Claes ◽  
Dirk Smits ◽  
Olaf Gefeller ◽  
Anja Hilbert ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Discriminant Validity ◽  
Factor Model ◽  
Population Based ◽  
Exercise Dependence ◽  
German Population ◽  
German Version ◽  
Internal Reliability ◽  
Eating Disorder Examination ◽  
Dependence Scale

This study evaluated the psychometric properties of the German version of the 21-item Exercise Dependence Scale (EDS-G), which was administered in a large representative German sample (N = 1,611). In order to examine convergent validity, we also asked participants to answer the Eating Disorder Examination-Questionnaire (EDE-Q). To investigate the discriminant validity, clients of fitness centers (N = 129), sport students (N = 85), and medical students (N = 129) filled out the EDS-G. In this German population-based sample, the seven-factor structure suggested by the original authors as well as a higher-order model (7 + 1 factor model) were supported. The total EDS-G scale showed an excellent internal reliability and was positively related to the EDE-Q total and subscale scores. The EDS-G scores differentiated between samples with varying degrees of exercise. In summary, the results indicate that the EDS-G is a psychometrically sound and potentially valid brief measure for the assessment of exercise dependence symptoms.

The Type D Construct

2014 ◽  
Vol 30 (4) ◽  
pp. 283-288 ◽  
Author(s):  
Gesine Grande ◽  
Matthias Romppel ◽  
Matthias Michal ◽  
Elmar Brähler
Keyword(s):  
Social Functioning ◽  
Negative Affectivity ◽  
Population Based ◽  
Type D Personality ◽  
Social Orientation ◽  
German Population ◽  
Social Competencies ◽  
Social And Emotional ◽  
Type D ◽  
Worse Prognosis

The interaction of negative affectivity (NA) and social inhibition (SI), known as the Type D personality, is associated with a worse prognosis in cardiac patients. Until now, causal models have been speculative, and this is partly due to a lack of clarity related to the validity of SI, its role in emotion regulation, and the postulated independence of social and emotional functioning. To examine the construct validity of the Type D personality, we analyzed associations of NA and SI with different measures of affectivity, social anxiety, and social competencies in a German population-based representative sample (n = 2,495). Both NA and SI were associated with all other measures of social functioning and negative affect (all rs > .30) and showed considerable cross-loadings (NA: a 1 = .39, a 2 = .63; SI: a1 = .73 and a2 = .34) in a two-factor solution with the factors labeled as Social Functioning and Negative Affectivity. The SI subscale did not properly differentiate between social fears and social competencies, which emerged as rather different aspects of social functioning. Further studies should examine the effect of broader dimensions of social orientation and competencies and their interaction with NA on cardiac prognosis.

Association between reproductive factors and postmenopausal osteoporosis

2011 ◽  
Vol 20 (03) ◽  
pp. 248-251
Author(s):  
H. R. Meybodi ◽  
N. Khalili ◽  
P. Khashayar ◽  
R. Heshmat ◽  
A. Hossein-nezhad ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Reproductive Factors ◽  
Population Based ◽  
Age At Menarche ◽  
Mineral Density ◽  
Cross Sectional ◽  
Number Of Children ◽  
Menstrual History ◽  
Duration Of Breastfeeding

SummaryThe present cross-sectional research was designed to study possible correlations between clinical reproductive factors and bone mineral density (BMD) values.Using the data gathered by the population-based Iranian Multicenter Osteoporosis Study (IMOS), we investigated the correlation found between reproductive factors and osteoporosis. Subjects were recruited from five major cities of Iran. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry and the results were analyzed against the age at menarche and at menopause, number of pregnancies, children and abortions, and the history (and duration) of breastfeeding.Data was available for 2528 women. Gravidity and number of children were reversely correlated with BMD. Younger age at menarche was associated with higher BMD values, whereas there was no significant correlation between age at menopause and menstrual history and BMD.Our study suggests that clinical reproductive factors, particularly number of children and breastfeeding, could be incorporated as predictors of BMD levels in women. Given the controversial results obtained in different studies, longitudinal studies should be carried out to enlighten the importance of these factors and the rationale of their use to predict BMD values in different settings.

Incidence of paediatric 10-fold medication errors in Wales

2020 ◽  
pp. archdischild-2020-319130
Author(s):  
Yincent Tse ◽  
David Tuthill
Keyword(s):  
Medication Errors ◽  
Reporting System ◽  
Patient Characteristics ◽  
Population Based ◽  
Population Surveillance ◽  
Near Miss ◽  
Surveillance Study ◽  
High Resource ◽  
Improvement Strategies ◽  
Iatrogenic Harm

ObjectivesTo estimate the incidence, characteristics and outcomes of 10-fold or greater or a tenth or less medication errors in children aged <16 years in Wales.DesignPopulation-based surveillance study July 2017 to June 2019. Cases were identified by paediatricians and hospital pharmacists using monthly electronic Welsh Paediatric Surveillance Unit (WPSU) reporting system.Patients‘Definite’ incident occurred when children received all or any of the incorrect dose of medication. ‘Near miss’ was where the prescribed, prepared or dispensed medication was not administered to the child.Main outcome measuresIncidence, patient characteristics, setting, drug characteristics, outcome, harm and enabling or preventive factors.ResultsIn total, 50 10-fold errors were reported; 20 definite and 30 near miss cases. This yields a minimum annual incidence of 1 per 3797 admissions, or 4.6/100 000 children. Of these, 43 were overdoses and 7 underdoses. 33 incidents occurred in children <5 years of age. Overall, 37 different medications were involved with the majority, 31 cases, being administered enterally. Of these 31 enteral medication errors, all definite cases (10) had received liquid preparations. Temporary harm occurred in 5/20 (25%) definite cases with one requiring intensive care; all fully recovered.ConclusionsIn this first ever population surveillance study in a high-resource healthcare system, 10-fold errors in children were rare, sometimes prevented and uncommonly caused harm. We recommend country-wide improvements be made to reduce iatrogenic harm. Understanding the enabling and preventive factors may help national improvement strategies to reduce these errors.

scholarly journals Vision-related quality of life considering both eyes: results from the German population-based Gutenberg Health Study (GHS)

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Stefan Nickels ◽  
Alexander K. Schuster ◽  
Heike Elflein ◽  
Christian Wolfram ◽  
Andreas Schulz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Population Based ◽  
Health Study ◽  
German Population ◽  
Gutenberg Health Study ◽  
Related Quality

scholarly journals Diverging Trends in Age at First Myocardial Infarction: Evidence from Two German Population-Based Studies

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Johannes Beller ◽  
Johann Bauersachs ◽  
Andreas Schäfer ◽  
Lars Schwettmann ◽  
Margit Heier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Population Based ◽  
German Population ◽  
First Myocardial Infarction

scholarly journals Costs and effects of conventional vision screening and photoscreening in the Dutch preventive child health care system

2020 ◽  
Author(s):  
Catharina P B Van der Ploeg ◽  
Manon Grevinga ◽  
Iris Eekhout ◽  
Eline Vlasblom ◽  
Caren I Lanting ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Population Based ◽  
Cross Sectional Study ◽  
Child Health Care ◽  
Test Duration ◽  
Vision Screening ◽  
Cross Sectional ◽  
Number Of Children ◽  
Preventive Child Health Care

Abstract Background Little is known about costs and effects of vision screening strategies to detect amblyopia. Aim of this study was to compare costs and effects of conventional (optotype) vision screening, photoscreening or a combination in children aged 3–6 years. Methods Population-based, cross-sectional study in preventive child health care in The Hague. Children aged 3 years (3y), 3 years and 9 months (3y9m) or 5–6 years (5/6y) received the conventional chart vision screening and a test with a photoscreener (Plusoptix S12C). Costs were based on test duration and additional costs for devices and diagnostic work-up. Results Two thousand, one hundred and forty-four children were included. The estimated costs per child screened were €17.44, €20.37 and €6.90 for conventional vision screening at 3y, 3y9m and 5/6y, respectively. For photoscreening, these estimates were €6.61, €7.52 and €9.40 and for photoscreening followed by vision screening if the result was unclear (combination) €9.32 (3y) and €9.33 (3y9m). The number of children detected with amblyopia by age were 9, 14 and 5 (conventional screening), 6, 13 and 3 (photoscreening) and 10 (3y) and 15 (3y9m) (combination), respectively. The estimated costs per child diagnosed with amblyopia were €1500, €1050 and €860 for conventional vision screening, €860, €420 and €1940 for photoscreening and €730 (3y) and €450 (3y9m) for the combination. Conclusions Combining photoscreening with vision screening seems promising to detect amblyopia in children aged 3y/3y9m, whereas conventional screening seems preferable at 5/6y. As the number of study children with amblyopia is small, further research on the effects of these screening alternatives in detecting children with amblyopia is recommended.

scholarly journals Decreased serum TSH levels are not associated with mortality in the adult northeast German population

2010 ◽  
Vol 162 (3) ◽  
pp. 579-585 ◽  
Author(s):  
Till Ittermann ◽  
Robin Haring ◽  
Sybille Sauer ◽  
Henri Wallaschofski ◽  
Marcus Dörr ◽  
...  
Keyword(s):  
Cancer Mortality ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
German Population ◽  
Free Triiodothyronine ◽  
Meta Analyses ◽  
Serum Tsh ◽  
Tsh Levels

ObjectiveResults of cohort studies on the association between decreased serum TSH levels and mortality are conflicting. Some studies demonstrated an increased mortality risk in subjects with decreased serum TSH levels, others did not. Even meta-analyses revealed contradictory results. We undertook the present study to investigate the association between decreased serum TSH levels and mortality in the large population-based Study of Health in Pomerania (SHIP).Design and methodsData from 3651 individuals from SHIP without known thyroid disorders or thyroid treatment were analyzed. Serum TSH, free triiodothyronine, and free thyroxine levels were determined by immunochemiluminescent procedures. Decreased TSH was defined as serum TSH levels below 0.25 mIU/l. Cox regression was used to associate decreased TSH levels with mortality.ResultsThe median duration of follow-up was 8.5 years (30 126 person years). During follow-up, 299 individuals (6.9%) died corresponding to a death rate of 9.92 deaths per 1000 person years. Survival time was shorter in subjects with decreased serum TSH levels compared to euthyroid individuals. After adjustment for age and sex, however, there was no association between decreased serum TSH levels and all-cause mortality (hazard ratio: 0.95; 95% confidence interval: 0.67; 1.36). Likewise, decreased serum TSH levels were neither associated with cardiovascular nor with cancer mortality.ConclusionsThere is no independent association of decreased serum TSH levels with all-cause, cardiovascular, and cancer mortality in the adult northeast German population. Although our study has some strengths, we cannot finally conclude on therapeutical implications in individuals with subclinical thyroid diseases.

scholarly journals Caring for HIV-positive children: healthcare providers' pre-and post-disclosure experiences in Nairobi, Kenya

2019 ◽  
Vol 13 (3) ◽  
pp. 1-7
Author(s):  
Drusilla Makworo ◽  
Theresa Odero
Keyword(s):  
Health Professionals ◽  
Healthcare Providers ◽  
Hiv Disclosure ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Number Of Children ◽  
High Resource ◽  
Main Challenge ◽  
Before And After ◽  
Sub Saharan

Background The number of children living with HIV has increased worldwide, largely due to improvements in antiretroviral therapy. Most of these children are living in sub-Saharan Africa. The rate of disclosure to children of their HIV-positive status is low in low-resource countries compared to high-resource countries. Aim To explore health professionals' experiences of caring for HIV-positive children before and after their HIV-positive status was disclosed to them. The health professionals included nurses, counsellors, nutritionists, social workers, pharmacists and clinicians with at least 1 year of experience at the paediatric section of the comprehensive care centre. Methods Nine health professionals were interviewed. Findings Results revealed that there were more challenges before disclosure than after. The main challenge was communicating with the children. The children's main concerns before disclosures included the reason for treatment and its duration, and clinic follow-up. Conclusions Health professionals should be trained on the benefits of HIV disclosure to children, in order to allow for open and direct communication between healthcare providers, parents/carers and children.

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