Activities of an Environmental Analysis Van in the German Federal State Schleswig-Holstein

Background: We have previously shown that multiple prior percutaneous coronary intervention (PCI) procedures adversely affect outcome after subsequent coronary artery bypass grafting (CABG). We were now interested to investigate this effect on a multicentric basis. Methods: Eight cardiac surgical centers from the German Federal State of North-Rhine-Westphalia provided outcome data of 37140 consecutive patients having undergone isolated first-time CABG between 01/2000 and 12/2005. Twenty-two patient characteristics and outcome variables, which are part of a collection of data claimed by the national medical quality-control commission, were retrieved from the individual databases. Three groups of patients were analyzed for overall in-hospital mortality and major adverse cardiac events (MACE): Patients without a previous PCI procedure, patients with 1 previous PCI procedure and patients with ≥2 previous PCI procedures before surgery. Unadjusted univariable and risk-adjusted multivariable logistic regression analysis were applied. Computed propensity-score matching was performed based on 15 patient major risk factors to correct for and minimize selection bias. Results: A total of 10.3% of patients had 1 previous PCI procedure, and 3.7% of patients had ≥2 previous PCI procedures. Risk-adjusted multivariable logistic regression analysis of ≥2 previous PCI significantly correlated with in-hospital mortality (odds ratio [OR], 2.0; confidence interval [CI], 1.4–3.0; P <0.0005) and MACE (OR, 1.5; CI, 1.2–1.9; P <0.0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of ≥2 previous PCI procedures was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; P =0.0016) and MACE (OR, 1.5; CI, 1.2–1.9; P =0.0019). Conclusions: This large multicentric trial supports earlier results of our single-center analysis, multiple previous PCI procedures significantly increased the event of in-hospital mortality and MACE after subsequent CABG.

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The ITS Master Plan of the German Federal State of Saxony-Anhalt

Communications in Computer and Information Science - Modern Transport Telematics ◽

10.1007/978-3-642-24660-9_5 ◽

2011 ◽

pp. 39-46 ◽

Cited By ~ 1

Author(s):

Susanne Jenkner ◽

Andreas Herrmann

Keyword(s):

Federal State ◽

Master Plan ◽

German Federal State

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Strategies of LMS Implementation at German Universities

Virtual Learning Environments ◽

10.4018/978-1-4666-0011-9.ch306 ◽

2012 ◽

pp. 522-541

Author(s):

Carola Kruse ◽

Thanh-Thu Phan Tan ◽

Arne Koesling ◽

Marc Krüger

Keyword(s):

Academic Staff ◽

Federal State ◽

Top Down ◽

Lower Saxony ◽

Online Tool ◽

General Aspects ◽

The University ◽

Different Levels ◽

German Federal State ◽

German Universities

In Germany, a learning management system (LMS) has become an everyday online tool for the academic staff and students at almost every university. Implementing an LMS, however, can be very different depending on the university. We introduce some general aspects on the strategies at German universities on how to implement an LMS. These aspects are mainly influenced by two main approaches, the top-down and bottom-up approach, which determine the decisions and actions on different levels at the university. In order to show how the strategies are carried out, we are presenting three case studies from universities based in the German federal state of Lower Saxony. We are going to reveal that both approaches play a part in each strategy, however differently weighted. It becomes clear that networking and collaboration plays a crucial role, not only concerning the technical development of the LMS software but also in organisational and educational terms.

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Strategies of LMS Implementation at German Universities

Higher Education Institutions and Learning Management Systems ◽

10.4018/978-1-60960-884-2.ch015 ◽

2012 ◽

pp. 315-334

Author(s):

Carola Kruse ◽

Thanh-Thu Phan Tan ◽

Arne Koesling ◽

Marc Krüger

Keyword(s):

Academic Staff ◽

Federal State ◽

Top Down ◽

Lower Saxony ◽

Online Tool ◽

General Aspects ◽

The University ◽

Different Levels ◽

German Federal State ◽

German Universities

In Germany, a learning management system (LMS) has become an everyday online tool for the academic staff and students at almost every university. Implementing an LMS, however, can be very different depending on the university. We introduce some general aspects on the strategies at German universities on how to implement an LMS. These aspects are mainly influenced by two main approaches, the top-down and bottom-up approach, which determine the decisions and actions on different levels at the university. In order to show how the strategies are carried out, we are presenting three case studies from universities based in the German federal state of Lower Saxony. We are going to reveal that both approaches play a part in each strategy, however differently weighted. It becomes clear that networking and collaboration plays a crucial role, not only concerning the technical development of the LMS software but also in organisational and educational terms.

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Characteristics of Recipients of Red Blood Cell Concentrates in a German Federal State

Transfusion Medicine and Hemotherapy ◽

10.1159/000510207 ◽

2020 ◽

Vol 47 (5) ◽

pp. 370-378

Author(s):

Linda Schönborn ◽

Kerstin Weitmann ◽

Andreas Greinacher ◽

Wolfgang Hoffmann

Keyword(s):

Blood Cell ◽

Red Blood Cell ◽

Population Decline ◽

Population Level ◽

Practice Change ◽

Federal State ◽

Treatment Practices ◽

Study Results ◽

Related Group ◽

German Federal State

Background: Annual transfusion rates in many European countries range between 25 and 35 red blood cell concentrates (RBCs)/1,000 population.It is unclear why transfusion rates in Germany are considerably higher (approx. 50–55 RBCs/1,000 population). Methods: We assessed the characteristics of transfusion recipients at all hospitals of the German federal state Mecklenburg-Western Pomerania during a 10-year longitudinal study. Results: Although 75% of patients received ≤4 RBCs/patient in 2015 (1 RBC: 11.3%; 2 RBCs: 42.6%; 3 RBCs: 6.3%; 4 RBCs: 15.0%), the mean transfusion index was 4.6 RBCs due to a minority of patients with a high transfusion demand. Two thirds of all RBCs were transfused to only 25% of RBC recipients. Consistently, male patients received a higher number of RBCs (2005: 54.2%; 2015: 56.8%) and had a higher mean transfusion index than female patients (mean 5.1 ± 7.2; median 2; inter-quartile range [IQR] 2–4 vs. mean 4.0 ± 5.8; median 2; IQR 2–4). The absolute transfusion demand decreased between 2005 and 2015 by 13.5% due to a composite of active reduction (clinical practice change) and population decline in the 65- to 75-year age group (lower birth rate cohort 1940–1950); however, with major differences between hospitals (range from –61.0 to +41.4%). Conclusion: Transfusion demand in a population could largely be driven by patients with high transfusion demand. Different treatment practices in this group of patients probably add to the major differences in transfusion demand per 1,000 individuals between countries. The available data cannot prove this hypothesis. Implementation of a diagnosis-related group-based monitoring system is urgently needed to allow informative monitoring on the population level and meaningful comparisons between transfusion practices.

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