Refine
Year of publication
Document Type
- Article (250) (remove)
Keywords
- Milchwirtschaft (35)
- Molkerei (27)
- Logistik (20)
- Bibliothek (8)
- India (8)
- Kostenschätzung (8)
- Software (8)
- Künstliche Intelligenz (7)
- Mumbai (7)
- PPS (7)
- Betriebsdatenerfassung (6)
- Signaltechnik (6)
- Klebeverbindung (5)
- Käserei (5)
- Produktion (5)
- Steuerung (5)
- Student (5)
- Unternehmen (5)
- Adhäsion (4)
- Computer (4)
- Indien (4)
- Informationsmanagement (4)
- Knowledge (4)
- Kommunikation (4)
- Kostenverlauf (4)
- Nigeria (4)
- Weichkäse (4)
- Wissen (4)
- clinical research (4)
- clinical trial (4)
- public reporting (4)
- Ausbildung (3)
- Automation (3)
- Betrieb (3)
- Biogas (3)
- CIM (3)
- E-Learning (3)
- Fertigung (3)
- Germany (3)
- Harmonische Analyse (3)
- Harmonische Synthese (3)
- Informationskompetenz (3)
- Interne Kommunikation (3)
- Kleben (3)
- Lieferung (3)
- Management (3)
- Milch (3)
- Mitarbeiter (3)
- OSGi (3)
- Pflege (3)
- Pharmaziestudent (3)
- University students (3)
- Zugscherversuch (3)
- e-learning (3)
- Attitude (2)
- Befragung (2)
- C-Bogen (2)
- C-arm (2)
- CEP (2)
- Change Management (2)
- Computerunterstütztes Lernen (2)
- Consumerization (2)
- Depression (2)
- Digitale Radiographie (2)
- Digitale Steuerung (2)
- ECA (2)
- Education (2)
- Einstellung (2)
- Erneuerbare Energien (2)
- Expertensystem (2)
- Flexibilität (2)
- Funktionsgenerator (2)
- General practitioners (2)
- Gouda <Käse> (2)
- H-Milch (2)
- HIV (2)
- Hannover (2)
- ISDN (2)
- Informationsvermittlung (2)
- Interdisciplinary communication (2)
- Joghurtherstellung (2)
- Konstruktion (2)
- Kostenrechnung (2)
- Lean Production (2)
- Mikrocomputer (2)
- Nursing homes (2)
- Personalkosten (2)
- Pharmacy (2)
- Physician-nurse relations (2)
- Polymere (2)
- Postmenopause (2)
- Produktionskosten (2)
- Produktionsprozess (2)
- Public reporting (2)
- Qualifikation (2)
- Qualitative research (2)
- Qualität (2)
- Quark (2)
- Regelenergie (2)
- Reserveleistung (2)
- SOA (2)
- Security (2)
- Selbstmedikation (2)
- Self-medication (2)
- Strategie (2)
- Students (2)
- Therapie (2)
- USA (2)
- USFDA (2)
- Unternehmensgründung (2)
- Wirtschaftlichkeit (2)
- computer based training (2)
- cost-effectiveness (2)
- data protection (2)
- developing country (2)
- direct benefit (2)
- information dissemination (2)
- information literacy (2)
- library (2)
- mastitis (2)
- mobile health (2)
- patient benefit (2)
- social benefit (2)
- transparency (2)
- virtual radiography (2)
- Absolvent (1)
- Absolventenbefragung (1)
- Adult Vaccines (1)
- Adverse drug event (1)
- Adverse drug reaction (1)
- Aerobes Training (1)
- Aerobic exercise (1)
- African socio-cultural context (1)
- Agent <Informatik> (1)
- Akzeptanz (1)
- Allergie (1)
- Ambulatory Monitoring (1)
- Android (1)
- Anforderung (1)
- Anmerkung (1)
- Antibiotic resistance (1)
- Antibiotics (1)
- Antibiotikum (1)
- Anwendung (1)
- Approval (1)
- Approvals (1)
- Arbeitsweise (1)
- Arzneimittelnebenwirkung (1)
- Arzneimittelüberwachung (1)
- Aspekt (1)
- Automatendiagramm (1)
- Automatische Identifikation (1)
- Autorität (1)
- Awareness (1)
- B-streptococci (1)
- BASIC (1)
- BDE (1)
- BLAST algorithm (1)
- Bachelor (1)
- Bacterial genomics (1)
- Balanced Scorecard (1)
- Bauphysik (1)
- Bedarfsplanung (1)
- Bedarfszeitpunkt (1)
- Bedienungstheorie (1)
- Benetzung (1)
- Berufsaussicht (1)
- Betriebsorganisation (1)
- Bibliotheksorganisation (1)
- Bibliothekswebseite (1)
- Bibliothekswissenschaft (1)
- Bildanalyse (1)
- Bildung (1)
- Bioactive peptides (1)
- Biofilm (1)
- Biomedical Informatics (1)
- Biometrie (1)
- Biosensor (1)
- Blackboard <Expertensystem> (1)
- Blutspende (1)
- Body composition (1)
- Bone mineral density (1)
- Boolesche Funktionstabelle (1)
- Bortedella (1)
- Bring Your Own Device (1)
- Brustdrüsenentzündung (1)
- Buch (1)
- Business Plan (1)
- Butter (1)
- C3 photosynthesis (1)
- CBR Express (1)
- CD4+ cell count (1)
- CRM in Hochschulen (1)
- Camembert (1)
- Care (1)
- Cellobiose (1)
- Centaurea behen (1)
- Childhood febrile conditions (1)
- Children (1)
- Clinical Trials (1)
- Clinical trial (1)
- Code (1)
- Coded Mark Inversion (1)
- Compliance (1)
- Computersicherheit (1)
- Continuous process (1)
- Controlling (1)
- Curriculum (1)
- DALY (1)
- Dach (1)
- Darstellendes Spiel (1)
- Datenerfassung (1)
- Datenpublikation (1)
- Datenschutz (1)
- Datenverarbeitung (1)
- Datenübertragung (1)
- Debatte (1)
- Decision Support Systems (1)
- Declaration of Helsinki (1)
- Decodierung (1)
- Delphi (1)
- Delphi method characteristics (1)
- Delphi method variants (1)
- Dempster-Shafer theory (1)
- Deutschland / Bundesverfassungsgericht (1)
- Developing Countries (1)
- Dezentralisation (1)
- Didaktik (1)
- Digitale Nebenstellenanlage (1)
- Digitalsignal (1)
- Disease Burden (1)
- Disease burden (1)
- Diskriminierung (1)
- Diskriminierungsverbot (1)
- Distributed file systems (1)
- Dokumentarfilm (1)
- EEG (1)
- ELIZA (1)
- EMA (1)
- ESTEEM (1)
- Ebola-Virus (1)
- Einführung (1)
- Einkauf (1)
- Einzelfertigung (1)
- Elderly (1)
- Enduser Device (1)
- Energieeffizienz (1)
- Energieeinsparung (1)
- Engset formula (1)
- Engset-Formel (1)
- Enugu (1)
- Epilepsie (1)
- Epilepsy (1)
- Erfolg (1)
- Erfolgsfaktor (1)
- Erfordernis (1)
- Erlang formula (1)
- Erziehung (1)
- Ethik (1)
- European Union (1)
- Euterentzündung (1)
- Event Admin (EA) (1)
- Event monitoring (1)
- Fault tolerance (1)
- Feedback (1)
- Fenster (1)
- Fernsprechverkehr (1)
- Fertigungssteuerung (1)
- Film (1)
- Filmarchiv (1)
- Filmmuseum (1)
- Focus groups (1)
- Food protein (1)
- Foresight (1)
- Fouriersynthese (1)
- Frauenquote (1)
- FurB (1)
- Futurologie (1)
- Führung (1)
- Führungsstrategie (1)
- Gehobener Dienst (1)
- Gehorsam (1)
- Geistesgeschichte (1)
- Gemeinkosten (1)
- Gen (1)
- Gender (1)
- Gender Mainstreaming (1)
- Genehmigung (1)
- Generierung (1)
- Genomic databases (1)
- GeoNames (1)
- Geografische Daten (1)
- Geriatrie (1)
- Geschichte (1)
- Geschlecht (1)
- Geschlossene Unterbringung (1)
- Gesetzliche Krankenversicherung (1)
- Gesichtserkennung (1)
- Gesundheitsberufe (1)
- Gesundheitsinformationssystem (1)
- Gesundheitsschaden (1)
- Gleichbehandlung (1)
- Gleichberechtigung (1)
- Graphentheorie (1)
- Grounded theory (1)
- Gruppenarbeit (1)
- HAART (1)
- HPV (1)
- Hamburg (1)
- Hannover / Landesmedienstelle (1)
- Haus (1)
- Hausarzt (1)
- Health Informatics (1)
- Health Information Systems (1)
- Health Information Technology (1)
- Health Professionals (1)
- Health promotion (1)
- Healthy aging (1)
- Hearsay (1)
- Heil- und Hilfsmittel (1)
- Heilberuf (1)
- Heimerziehung (1)
- Herbarium (1)
- Hochschulausbildung (1)
- Hochschulbibliothek (1)
- Hochschule Hannover (1)
- Hochschule Hannover. Fakultät III - Medien, Information und Design (1)
- Hospital quality (1)
- Humanes Papillomavirus (1)
- Humanisierung der Arbeit (1)
- Hygiene (1)
- ISO 27 K (1)
- ISO 27001 (1)
- ISO 27002 (1)
- ISO/IEC 27000 (1)
- IT security (1)
- IT-Sicherheit (1)
- Identität (1)
- Immobilization (1)
- Impfstoff (1)
- Impfung (1)
- Implementation (1)
- Income (1)
- Infektion (1)
- Information (1)
- Information materials (1)
- Information systems research (1)
- Informations- und Dokumentationswissenschaft (1)
- Informationsethik (1)
- Informationssystem (1)
- Informationstechnik (1)
- Informationswissenschaft (1)
- Instandhaltung (1)
- Instrument (1)
- Insurance (1)
- Integriertes Engineering (1)
- Interne Unternehmenskommunikation (1)
- Internet (1)
- Internverkehr-Formel (1)
- Investitionsbedarf (1)
- Investitionsplanung (1)
- Jesuiten (1)
- Jesuits (1)
- Joseph (1)
- Jugendsozialarbeit (1)
- Kapitalplanung (1)
- Karachi (1)
- Katholische Kirche (1)
- Kind (1)
- Kind <11-13 Jahre> (1)
- Kinderkriminalität (1)
- Klebtechnik (1)
- Klein- und Mittelbetrieb (1)
- Knochenmineraldichte (1)
- Kollisionsverlust (1)
- Konferenz (1)
- Konstruktionsmerkmal (1)
- Konzeption (1)
- Korrektur (1)
- Kostenabschätzung (1)
- Kraftfahrzeugbau (1)
- Krafttraining (1)
- Krampf (1)
- Krankenpflege (1)
- Krankenpflegeausbildung (1)
- Kreatives Denken (1)
- Kreativität (1)
- Kriminalität (1)
- Kritische Masse (1)
- Kundenorientierung (1)
- Kunststoff (1)
- Kurs (1)
- Kältetechnik (1)
- Körperbau (1)
- Körperfett (1)
- Leaves (1)
- Lebanon (1)
- Lebensmitteleinzelhandel (1)
- Lebensmittelgroßhandel (1)
- Lebensqualität (1)
- Lehrer (1)
- Lehrorganisation (1)
- Leitstand (1)
- Lernen (1)
- LightSabre (1)
- Linked Open Data (1)
- Liquidität (1)
- Liquiditätsplan (1)
- Liquiditätsplanung (1)
- Logiksynthese (1)
- Ländlicher Raum (1)
- Magermilch (1)
- Maharashtra (1)
- Malnutrition (1)
- Manchester (1)
- MapReduce algorithm (1)
- Marketing (1)
- Materialfluss (1)
- Matrix (1)
- Matunga (1)
- Medical Ethics (1)
- Medical Informatics (1)
- Medical devices (1)
- Mediothek (1)
- Meisterfertigung (1)
- Merkmal (1)
- Messtechnik (1)
- Metadaten (1)
- Metagenomics (1)
- Metall (1)
- Metalloregulator (1)
- Microorganism (1)
- Mikrowaage (1)
- Milchkuh (1)
- Milchsäurebakterien (1)
- Mitarbeiterbindung (1)
- Mitarbeitermanagement (1)
- Mitarbeiterzufriedenheit (1)
- Mittelstand (1)
- Mobile (1)
- Mobile Applications (1)
- Mobile Auskunft (1)
- Mobile Device (1)
- Mobile Device Management (1)
- Modellvorhaben (1)
- Modifizierung (1)
- Mothers’ perception of recovery (1)
- Mothers’ satisfaction (1)
- Motorisches Gleichgewicht (1)
- Multimedia Retrieval (1)
- Mumbai, India (1)
- Mundhöhlenkrebs (1)
- Muscle strength (1)
- Muskelkraft (1)
- Mycobacteria (1)
- Möglichkeit (1)
- Nachrichtentechnik (1)
- Nanomedicine (1)
- Nanotechnology (1)
- Nanotoxicity (1)
- Netzwerk <Graphentheorie> (1)
- Netzübergang (1)
- Neuronales Netz (1)
- Niederdruckplasma (1)
- Niedersachsen (1)
- Niedrige Energie (1)
- NoSQL databases. (1)
- Nutzung (1)
- Oberflächenbehandlung (1)
- Online-Portal (1)
- Ontologies (1)
- Optimalliquidität (1)
- Optische Zeichenerkennung (1)
- Oral cancer (1)
- Organisation (1)
- Organisatorische Aspekte (1)
- Orthopädische Chirurgie (1)
- Ortsnetz (1)
- Oszillatorschaltung (1)
- PC-gestützt (1)
- PCR (1)
- PICA <Bibliotheksinformationssystem> (1)
- Pakistan (1)
- Patent medicine dealers (1)
- Patient (1)
- Patient care (1)
- Patient counselling (1)
- Patient experience (1)
- Patient referral (1)
- Perception (1)
- Pflegeberufereformgesetz (1)
- Pflegedidaktik (1)
- Pharmacovigilance (1)
- Pharmazie (1)
- Physician rating website (1)
- Physician rating websites (1)
- Physician-rating website (1)
- Physiotherapeut (1)
- Pilot Projects (1)
- Plan (1)
- Planung (1)
- Polymer-Metall-Verbund (1)
- Polytetrafluorethylene (1)
- Postmenopausal women (1)
- Poststroke depression (1)
- PowerSim (1)
- Preisbildung (1)
- Preisdifferenzierung (1)
- Preissetzung (1)
- Prevention (1)
- Primary health care (1)
- Problem (1)
- Problemlösen (1)
- Prognose (1)
- Programm (1)
- Programmierung (1)
- Proteases (1)
- Prozesskette (1)
- Prämenopause (1)
- Prüfungsangst (1)
- Psychologie (1)
- Public health (1)
- Quality measures (1)
- Quality of Life (1)
- Quality of care (1)
- Quality of health care (1)
- Qualitätsmanagement (1)
- Qualitätssicherung (1)
- Quarz (1)
- Queuing theory (1)
- Quotierung (1)
- Raigad (1)
- Rationalität (1)
- Rauchen (1)
- Regelkreis (1)
- Regenerative Digitalsignalübertragung (1)
- Regulation (1)
- Regulations (1)
- Residential facilities (1)
- Resistance exercise (1)
- Resistenz (1)
- Ressourcen (1)
- Ressourceneinsatz (1)
- Roving Librarian (1)
- Rubber (1)
- Rufsperrung (1)
- Rural community (1)
- S. aureus (1)
- SOAP (1)
- Schadensersatzanspruch (1)
- Schlaganfallpatient (1)
- Schlüsselfaktor (1)
- Schlüsselkompetenzen (1)
- Schnittkäse (1)
- Seizures (1)
- Semantic Web (1)
- Sensor (1)
- Sequence alignment (1)
- Service Lifecycle (1)
- Service Management (1)
- Service Monitoring (1)
- Service Registry (1)
- Service Repository (1)
- Service Semantics (1)
- Serviceorientierte Architektur (1)
- Sicherung (1)
- Signalgenerator (1)
- Smart Device (1)
- Smoking (1)
- Soft Skills (1)
- Soll-Ist-Vergleich (1)
- Sonnenenergie (1)
- Soziale Gerechtigkeit (1)
- Soziale Gruppenarbeit (1)
- Stadt (1)
- Stand der Technik (1)
- Staphylococcaceae (1)
- Staphylococcus aureus (1)
- Statutory Health (1)
- Steuerungsstruktur (1)
- Steuerungssystem (1)
- Steuerungstechnik (1)
- Strahlenschutz (1)
- Strategic Information Management (1)
- Strategische Vorausschau (1)
- Streptococcus uberis (1)
- Streustrahlung (1)
- Struktur (1)
- Studiengangfinder (1)
- Sturz (1)
- Symposion (1)
- Symptom (1)
- Synononym (1)
- System (1)
- Systematic review (1)
- Systematik (1)
- Szenisches Spiel (1)
- TDMA (1)
- Tabakkonsum (1)
- Tagungsbericht (1)
- Tala (1)
- Target groups (1)
- Taxonomy (1)
- Teaching Librarian (1)
- Telekommunikation (1)
- Terminplanung (1)
- Terminsteuerung (1)
- Text Segmentation (1)
- Textroutinen (1)
- Thesaurus (1)
- Third-Party-Elemente (1)
- Tiefeninterview (1)
- Time-Division Multiplex Communication Network (1)
- Tobacco (1)
- Traffic theory (1)
- Tragfähigkeit (1)
- Transfer of medical tasks (1)
- Trendanalyse (1)
- Trockenmilch (1)
- Turing-Test (1)
- Type 2 diabetes mellitus (1)
- Unerwünschte Arzneimittelwirkung (1)
- Unfallchirurgie (1)
- Unfallrisiko (1)
- University Students (1)
- Unsicherheit (1)
- Unternehmensführung (1)
- User Generated Content (1)
- VIVO (1)
- Vaccine (1)
- Verbesserung (1)
- Verbundwerkstoffe (1)
- Verkehrstheorie (1)
- Verlustsystem (1)
- Verlustwahrscheinlichkeiten (1)
- Vermittlungssystem (1)
- Veränderungsbereitschaft (1)
- Veränderungsprozess (1)
- Video Segmentation (1)
- Vielfachzugriff (1)
- Voluntary blood donation (1)
- Voraussetzung (1)
- Vorgehensmodell (1)
- WS-Security (1)
- Walking balance (1)
- Water resources (1)
- Web log (1)
- Web service (1)
- Web services (1)
- Web-Portal (1)
- Weizenbaum (1)
- Werkstoffverbunde (1)
- Wertschöpfungsprozess (1)
- Wettbewerbsvorsprung (1)
- Wirtschaft (1)
- Wissenschaftliches Arbeiten (1)
- Wissensmanagement (1)
- Wohnungsbau (1)
- Workload (1)
- World Wide Web 2.0 (1)
- X-ray (1)
- ZX 81 (1)
- Zeitfaktor (1)
- Zeitpunkt (1)
- Zeitwirtschaft (1)
- Zerstäubungstrocknung (1)
- Ziel (1)
- Zinc homeostasis (1)
- Zufriedenheit (1)
- Zukunftsforschung (1)
- Zur (1)
- Zusammengehörigkeit (1)
- acceptance (1)
- accidental falls (1)
- aeroallergen (1)
- aerosol exposure (1)
- agents (1)
- alternative treatment (1)
- anforderungsgerecht (1)
- antibiotics (1)
- antidiabetic (1)
- antihypertensive (1)
- antimicrobials (1)
- antioxidants (1)
- antiviral therapy (1)
- asthma (1)
- asynchronous messaging (1)
- author (1)
- authority (1)
- bacterial pathogens (1)
- bauphysikalisch (1)
- belief (1)
- bioethics (1)
- biofilm (1)
- biomedicine (1)
- blood (1)
- body fat mass (1)
- broth microdilution (1)
- call congestion (1)
- cashing (1)
- childhood (1)
- clinical mastitis (1)
- clinical trials (1)
- cloud computing (1)
- complex event processing (1)
- complex event processing (CEP) (1)
- computed tomography (1)
- conceptual history (1)
- contagious mastitis (1)
- cranial cavity (1)
- creativity (1)
- critical mass (1)
- culture (1)
- cytomegalovirus (1)
- dairy cattle (1)
- dairy cattle (1)
- dairy cow (1)
- data mining (1)
- dentist (1)
- developing countries (1)
- diabetes mellitus (1)
- differenziert (1)
- digital divide (1)
- discrete tomography (1)
- distributed environments (1)
- distributed evacuation coordination (1)
- doctor-patient communication (1)
- drug-monitoring (1)
- editor (1)
- eigenface (1)
- enterprise apps (1)
- ethanolic extract (1)
- ethics (1)
- ethics indirect benefit (1)
- ethnomedicine (1)
- evacuation guidance (1)
- events (1)
- examination (1)
- face recognition (1)
- fear (1)
- flexible Betriebsorganisation (1)
- free radicals (1)
- gait output (1)
- general practitioners (1)
- genotypes (1)
- geriatric assessment (1)
- hand grip strength (1)
- healing (1)
- health care (1)
- horse (1)
- hurdle model (1)
- hypertension (1)
- identity, Catholic Church (1)
- immunomonitoring (1)
- immunosuppression (1)
- in-depth-interviews (1)
- indirect benefit (1)
- information presentation (1)
- intellectual history (1)
- internal traffic formula (1)
- internet (1)
- kidney transplantation (1)
- kreativität (1)
- lactic acid bacteria (1)
- large scale systems (1)
- limited angle (1)
- load balancing (1)
- loss probabilities (1)
- loss system (1)
- mHealth (1)
- malnutrition (1)
- marktorientiert (1)
- medical data (1)
- medical devices (1)
- menopause (1)
- mikrocomputergesteuerter Generator (1)
- model selection (1)
- modifiable characteristics of the vulnerable patients (1)
- multiple access (1)
- multivariate data (1)
- musculoskeletal disorders, (1)
- non-prescription (1)
- noninferiority (1)
- obedience (1)
- occupational disorders (1)
- online ratings (1)
- ontology (1)
- organizational aspects (1)
- orthopaedic surgery (1)
- osseous landmarks (1)
- outcome measurement (1)
- over-immunosuppression (1)
- overdispersion (1)
- patient narratives (1)
- patient satisfaction (1)
- patients (1)
- pediatric transplantation (1)
- peer review (1)
- personalized immunosuppressive therapy (1)
- physician choice making (1)
- physician-rating website (1)
- placebo (1)
- poisson regression (1)
- polymerase chain reaction (1)
- privacy (1)
- probiotic potential (1)
- procedural model (1)
- proteolytic enzymes (1)
- publication bias (1)
- pulmonary inflammation (1)
- questionnaire (1)
- radiation protection (1)
- rationalität (1)
- real-time routing (1)
- recursive calculation (1)
- reducing ability (1)
- rekursive Berechnung (1)
- reliable message delivery (1)
- report cards (1)
- roads to health (1)
- rollierend (1)
- scattered radiation (1)
- self-medication (1)
- self-prescription (1)
- semantic web application (1)
- sensor-based mobile gait analysis (1)
- shopping cart system (1)
- situation aware routing (1)
- smartphone (1)
- social justice (1)
- socioeconomic demographic determinants (1)
- sports ability (1)
- standard of care (1)
- staphylococci (1)
- startup (1)
- stride ratio (1)
- student project (1)
- survey (1)
- swine (1)
- switching system (1)
- symptoms of post-stroke depression (1)
- synchronisiert (1)
- systematic review (1)
- tablet (1)
- testing (1)
- total knee arthroplasty (1)
- trauma surgery (1)
- ultrafine particles (1)
- underdispersion (1)
- underprivileged adolescents (1)
- user training (1)
- veterinary epidemiology (1)
- viral infections (1)
- virtX (1)
- virulence genes (1)
- virus-specific T cells (1)
- web services (1)
- zero inflation (1)
- Änderung (1)
- Öffentlichkeitsarbeit (1)
- Übertragung von Heilkunde (1)
- Übertragungsplan (1)
Noch bis vor wenigen Jahren galt die interne Kommunikation in den meisten Unternehmen im Vergleich zur Kommunikation mit externen Zielgruppen als deutlich weniger anspruchsvoll oder gar als in irgendeiner Weise wettbewerbsrelevant. Wurde sie lange als reine Sozialleistung betrachtet, rückt sie nun - insbesondere vor dem Hintergrund voranschreitender Globalisierung und ihren Auswirkungen auf die Wettbewerbsfähigkeit der Unternehmen - langsam als strategisches Führungsinstrument in das Bewusstsein vieler Unternehmenslenker. Denn mehr und mehr wird deutlich, dass die eigenen Mitarbeiter ausschlaggebender Faktor bei der Bewältigung von Veränderungen sind.
Objectives: To assess the relation between the number of clinical trials conducted and respective new drug approvals in India and South Africa.
Design: Construction and analysis of a comprehensive database of completed randomised controlled clinical trials based on clinicaltrials.gov from 1 January 2005 to 31 December 2010 and drug approval data from 2006 until 2013 for India and South Africa.
Setting: USA, the EU, India and South Africa.
Main outcome measures: Percentage of completed randomised clinical trials for an Investigational Medicinal Product (IMP) leading to new drug approval in India and South Africa.
Results: A total of 622 eligible randomised controlled trials were identified as per search criteria for India and South Africa. Clustering them for the same sponsor and the same Investigational New Drug (IND) resulted in 453 eligible trials, that is, 224 for India and 229 for South Africa. The distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centres in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorisation in the EU/USA without a New Drug Application (NDA) approval in India or South Africa.
Conclusions: Despite an increase in clinical trial activities, there is a clear gap between the number of trials conducted and market availability of these new drugs in India and South Africa. Drug regulatory authorities, investigators, institutional review boards and patient groups should direct their efforts to ensuring availability of new drugs in the market that have been tested and researched on their population.
BACKGROUND: Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE). METHODS: Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information. RESULTS: Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication. CONCLUSIONS: Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.
In this paper, we consider the route coordination problem in emergency evacuation of large smart buildings. The building evacuation time is crucial in saving lives in emergency situations caused by imminent natural or man-made threats and disasters. Conventional approaches to evacuation route coordination are static and predefined. They rely on evacuation plans present only at a limited number of building locations and possibly a trained evacuation personnel to resolve unexpected contingencies. Smart buildings today are equipped with sensory infrastructure that can be used for an autonomous situation-aware evacuation guidance optimized in real time. A system providing such a guidance can help in avoiding additional evacuation casualties due to the flaws of the conventional evacuation approaches. Such a system should be robust and scalable to dynamically adapt to the number of evacuees and the size and safety conditions of a building. In this respect, we propose a distributed route recommender architecture for situation-aware evacuation guidance in smart buildings and describe its key modules in detail. We give an example of its functioning dynamics on a use case.
Background: After kidney transplantation, immunosuppressive therapy causes impaired cellular immune defense leading to an increased risk of viral complications. Trough level monitoring of immunosuppressants is insufficient to estimate the individual intensity of immunosuppression. We have already shown that virus-specific T cells (Tvis) correlate with control of virus replication as well as with the intensity of immunosuppression. The multicentre IVIST01-trial should prove that additional steering of immunosuppressive and antiviral therapy by Tvis levels leads to better graft function by avoidance of over-immunosuppression (for example, viral infections) and drug toxicity (for example, nephrotoxicity).
Methods/design: The IVIST-trial starts 4 weeks after transplantation. Sixty-four pediatric kidney recipients are randomized either to a non-intervention group that is only treated conservatively or to an intervention group with additional monitoring by Tvis. The randomization is stratified by centre and cytomegalovirus (CMV) prophylaxis. In both groups the immunosuppressive medication (cyclosporine A and everolimus) is adopted in the same target range of trough levels. In the non-intervention group the immunosuppressive therapy (cyclosporine A and everolimus) is only steered by classical trough level monitoring and the antiviral therapy of a CMV infection is performed according to a standard protocol. In contrast, in the intervention group the dose of immunosuppressants is individually adopted according to Tvis levels as a direct measure of the intensity of immunosuppression in addition to classical trough level monitoring. In case of CMV infection or reactivation the antiviral management is based on the individual CMV-specific immune defense assessed by the CMV-Tvis level. Primary endpoint of the study is the glomerular filtration rate 2 years after transplantation; secondary endpoints are the number and severity of viral infections and the incidence of side effects of immunosuppressive and antiviral drugs.
Discussion: This IVIST01-trial will answer the question whether the new concept of steering immunosuppressive and antiviral therapy by Tvis levels leads to better future graft function. In terms of an effect-related drug monitoring, the study design aims to realize a personalization of immunosuppressive and antiviral management after transplantation. Based on the IVIST01-trial, immunomonitoring by Tvis might be incorporated into routine care after kidney transplantation.
The objective of this student project was for the students to develop, conduct, and supervise a training course for basic work place applications (word processing and business graphics). Students were responsible for the planning, organizing and the teaching of the course. As participants, underprivileged adolescents took part in order to learn the handling of IT applications and therefore, improve their job skills and have a better chance to get into employment. Therefore the adolescents do the role of trainees at the course. Our students worked with a population that is continually overlooked by the field.
As a result, the students trained to design and implement training courses, exercised to manage projects and increased their social responsibility and awareness concerning the way of life and living conditions of other young people. The underprivileged adolescents learned to use important business applications and increased their job skills and job chances. The overall design of our concept required extensive resources to supervise and to steer the students and the adolescents. The lecturers had to teach and to counsel the students and had to be on “stand-by” just in case they were needed to solve critical situations between the two groups of young people.
Background: Immunization is the most cost-effective intervention for infectious diseases which are the major cause of morbidity and mortality worldwide. There is a scarcity of information on the vaccination status of young adults and the role of socioeconomic conditions in India. Objectives: Present study explored the adult vaccination status and influence of income and education of parents on adult vaccination status in university students from Mumbai, India.
Methods: On the basis of the eligibility criterion 149 students were selected for the present study. A total of 8 vaccines namely Tdap/DTP, Varicella, MMR, Influenza, Pneumococcal, Hepatitis A, Hepatitis B and Meningococcal were included in this study for all the respondents. In addition to these vaccines, Human Papilloma Virus vaccine was also included for female respondents.
Results: There were total of 149 (75 male and 74 females) respondents with the mean age of 21.5 years. The top 3 immunizations were Td/Tdap (97.3%), MMR (66.4%) and Hepatitis B (55%) among the respondents. Only 4 (5.5%) female respondents have been immunized against the HPV. Conclusions: Td/Tdap (97.3%) and MMR (66.4%) coverage was in line with the recommendations. For all the other vaccines the coverage was low varying from 5.5% to 35.4%. The vaccination coverage was better in respondents with higher educated and higher income parents. We suggest that patient education, planning by government for the implementation of policy for adult vaccination and involvement of physicians are must for better adult vaccination coverage.
The drugs we use to treat any condition – from an innocuous cough to a life-threatening cancer – are the outcome of painstaking human clinical trials. These trials are the only way to credibly determine the safety and efficacy of drugs. In recent years there has been a clear shift in clinical trial sites from core developed countries like USA, European countries to developing countries like India, China, South American countries. This shift is related to challenges and opportunities like costs of trials, recruitment issues, and regulatory challenges in developed vs. developing countries. Developing countries and developed countries have their unique disease burden patterns based on various parameters like but not limited to age, health care facilities, health insurance, sanitary conditions, environmental issues, education, nutrition
and GDP. Previous studies have reported that many of the important global diseases are not much explored in clinical trials and many published clinical trials have very less international health relevance. This study was aimed at finding the correlation between disease burdens, number of clinical trials done and trial success rates. We compared 2005 - 2010 Global Burden of Disease data for Germany, India and number of clinical trials from clinicaltrials.gov database done in the same period. Our findings indicated that there was a good correlation between the disease burden and clinical trials for Germany in 2005 and 2010. For India in 2005 there was a moderate positive correlation, 2010 data showed the improvement in India in terms of match between disease burden and clinical trials. But careful observation of the data shows still a need for more trials on Communicable, maternal, neonatal and nutritional disorders.
Background: Pharmacovigilance (PV); also known as drug safety surveillance, is the science of enhancing patient care and patient safety regarding the use of medicines by collecting, monitoring, assessing, and evaluating information from healthcare providers and patients. Pharmacists are pivotal players in adverse drug event (ADE) monitoring and reporting. However, most pharmacists are unaware or not knowledgeable about the guidelines used by their respective countries’ drug regulatory bodies. It is the need of the hour to train pharmacy students on the concept of pharmacovigilance.
Methods: A cross-sectional study was carried out among pharmacy students from Mumbai University, India during May-June 2017. On the basis of the eligibility criterion 352 students were selected for the present study. Four hundred students were approached to participate in the study of which 201 agreed to participate (males: 179; females: 173). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Overall pharmacovigilance knowledge (44%) and perception (58%) was low among the participants of the present study. Seventy four percent of the participants felt that adverse drug reaction (ADR) reporting should be made compulsory for healthcare professionals. And only 21% agreed that the topic of Pharmacovigilance is well covered in pharmacy curriculum.
Conclusions: Pharmacy council of India, pharmacy teacher’s association and respective pharmacy college should take necessary steps to increase the knowledge and create awareness regarding pharmacovigilance and adverse drug reaction reporting among pharmacy students.