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2.
Front Health Serv ; 4: 1372522, 2024.
Article in English | MEDLINE | ID: mdl-38545382

ABSTRACT

Introduction: Since 2019 people who have insured in the German statutory health insurance are entitled to use certified apps called the Digitale Gesundheitsanwendungen [Digital Health Applications (DiGAs)]. The prerequisite for this is that an app certified as DiGA and suitable for their diagnosis exists. The DiGA can then either be prescribed by a physician or psychotherapist or requested by the patient from the statutory health insurance fund. Given the novelty of this type of healthcare, the implementation of a DiGA should be closely monitored to identify potential weaknesses and achieve quality improvements. To enable an analysis of the supply of DiGAs step-by-step, we aimed to create the DiGA-Care Path. Methods: We conducted three steps to create the DiGA-Care Path. First, a knowledge base was created based on a structured literature research matched with knowledge gathered from the superordinate research project "QuaSiApps" funded by the German Federal Joint Committee. Second, we aimed to create an "ideal-typical" DiGA-Care Path using a flowchart. Third, based on the first path, a final path was developed using the graphical modeling language "Event-Driven Process Chain." Results: The DiGA-Care Path was developed to depict the supply of DiGAs in Germany. The final path is constituted by a "main path" as well as a corresponding "sub-path". While the "main path" focuses more on the supply environment in which a DiGA is used, the "sub-path" depicts the supply delivered by the DiGA itself. Besides the process itself, the paths include relevant actors to indicate responsibilities for individual process steps. Discussion: The DiGA-Care Path helps to analyze the current supply of DiGAs step-by-step. Thereby, each step can be investigated in detail to identify problems and to detect further steps where quality improvements can be enabled. Depending on the perspective, focused either on the supply environment, or the supply delivered by the DiGA itself, the "main path" or the "sub-path" can be used, respectively. Besides the potential of the DiGA-Care Path to improve the current supply of DiGAs, it can help as an orientation for international policymakers or further stakeholders either to develop their own integration of apps into healthcare systems or for international manufacturers to consider entering the German market.

3.
BMC Geriatr ; 23(1): 464, 2023 08 01.
Article in English | MEDLINE | ID: mdl-37525120

ABSTRACT

BACKGROUND: Alternative forms of housing for persons with dementia have been developed in recent decades. These concepts offer small groups of residents familiar settings combined with efforts to provide normal daily life. The aim of this systematic review is to collate and analyze these more innovative forms of housing regarding residents' quality of life, behavioral aspects, as well as functional, cognitive and emotional aspects. METHODS: Searches were conducted in PubMed, EMBASE and PsycInfo in November 2020. Studies comparing traditional and more innovative living environments for persons with dementia were eligible. Concepts are described based on the results of additional searches. Risk of bias of included studies was assessed using checklists from the Joanna Briggs Institute. RESULTS: A total of 21 studies corresponding to 11 different concepts were included, namely Green Houses (USA), Group Living (Sweden), Cantou (France), Group Homes (Japan), Small-scale Group Living (Austria), Special Care Facilities (Canada), Shared-housing Arrangements (Germany), Residential Groups (Germany), Residential Care Centers / Woodside Places (USA/Canada), Small-scale Living (Netherlands/ Belgium), and Green Care Farms (Netherlands). The concepts are broadly similar in terms of care concepts, but partly differ in group sizes, staff qualifications and responsibilities. Several studies indicate that innovative forms of housing may encourage social behavior, preserve activity performance and/or positively influence emotional status compared to more traditional settings, while other studies fail to demonstrate these effects. Some studies also show increased behavioral and psychological symptoms of dementia (BPSD) in residents who live in more innovative housing concepts. The effect on cognition remains indistinct. DISCUSSION: The positive effects may be attributable to the inherent characteristics, including small group sizes, a stimulating design, and altered staff roles and responsibilities. Arguably, some of these characteristics might also be the reason for increased BPSD. Studies had variable methodological quality and results have to be considered with caution. Future research should examine these effects more closely and should investigate populations' preferences with regards to housing in the event of dementia.


Subject(s)
Dementia , Quality of Life , Humans , Quality of Life/psychology , Social Behavior , Housing , Cognition , Dementia/diagnosis , Dementia/epidemiology , Dementia/therapy
5.
Urologe A ; 53(12): 1793-9, 2014 Dec.
Article in German | MEDLINE | ID: mdl-25297490

ABSTRACT

BACKGROUND: Prostate cancer (PCA) is the most common form of neoplasm in men and various treatment options are available. Knowledge of health-related quality of life (HRQL) can provide information to support informed decision-making. In addition, information on factors influencing HRQL can provide indications for the further development of medical treatment. The aim of the study was to obtain data on HRQL after inpatient treatment of PCA and the identification of determinants of HRQL after PCA in routine healthcare. MATERIALS AND METHODS: In this study a total of 1165 beneficiaries of a German health insurance with a hospital stay due to prostate cancer (ICD C61) were surveyed on their health-related quality of life using the European Organization for Research and Treatment of Cancer quality of life questionnaire version 3 (EORTC QLQ-C30 V3.0) and disease-specific symptoms using the perceived sensitivity to medicine (PSM) scale 14 months after discharge. Survey data were linked with pseudonymous claims data of the health insurance provider. Determinants of HRQL were examined by logistic regression. RESULTS: Responses from 825 men (mean age 67.6 years and 80% treated with radical prostatectomy) were available for analysis (response 70.8%). Compared to the reference population impairments in HRQL were reported especially in terms of the roles and social functionality. The prostate-specific symptoms varied depending on the treatment strategy. A nerve-sparing surgical technique reduced the likelihood of erectile dysfunction. Other protective factors were no pre-existing comorbidities and younger age. DISCUSSION: The effects of PCA on the HRQOL varied by age, comorbidities and treatment modality which should be considered in healthcare information and counseling of patients.


Subject(s)
Erectile Dysfunction/epidemiology , Erectile Dysfunction/psychology , Hospitalization/statistics & numerical data , Prostatic Neoplasms/psychology , Prostatic Neoplasms/surgery , Quality of Life/psychology , Adult , Age Distribution , Aged , Comorbidity , Erectile Dysfunction/prevention & control , Germany/epidemiology , Humans , Male , Middle Aged , Prevalence , Prostatectomy/psychology , Prostatectomy/statistics & numerical data , Prostatic Neoplasms/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome
6.
Phys Rev Lett ; 109(13): 137202, 2012 Sep 28.
Article in English | MEDLINE | ID: mdl-23030117

ABSTRACT

The spin-wave band structure of a two-dimensional bicomponent magnonic crystal, consisting of Co nanodisks partially embedded in a Permalloy thin film, is experimentally investigated along a high-symmetry direction by Brillouin light scattering. The eigenfrequencies and scattering cross sections are interpreted using plane wave method calculations and micromagnetic simulations. At the boundary of both the first and the second Brillouin zones, we measure a forbidden frequency gap whose width depends on the magnetic contrast between the constituent materials. The modes above and below the gap exhibit resonant spin-precession amplitudes in the complementary regions of periodically varying magnetic parameters. Our findings are key to advance both the physics and the technology of band gap engineering in magnonics.

7.
Phys Rev Lett ; 105(6): 067208, 2010 Aug 06.
Article in English | MEDLINE | ID: mdl-20868008

ABSTRACT

All-electrical spin-wave spectroscopy, Brillouin light scattering, as well as the magneto-optical Kerr effect are combined to study spin-wave propagation through a magnetic antidot lattice nanopatterned into a Ni(80)Fe(20) thin film. The propagation velocities and, in particular, the relaxation are found to depend characteristically on the applied in-plane magnetic field. We explain the observed anisotropies by magnetic field-controlled spin-wave guiding in a network of interconnected nanowires which takes place over distances of up to 20 µm.

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