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Studien zeigen, dass Anhänger der PEGIDA-Bewegung die Medienberichterstattung als unangemessen wahrnehmen und ihr misstrauen. Diese Wahrnehmung und daraus resultierende kognitive, affektive und konative Konsequenzen wurden in einer standardisierten Online-Befragung untersucht (n= 800). Es zeigt sich, dass Anhänger der PEGIDA-Bewegung der Berichterstattung über PEGIDA mehr misstrauen als PEGIDA-Gegner. Diese Wahrnehmung wiederum hat politisch relevante Konsequenzen: Je stärker PEGIDA-Anhänger und neutral Eingestellte der Berichterstattung misstrauen, desto weniger Vertrauen bringen sie den Medien allgemein entgegen, desto unzufriedener sind sie mit der Demokratie in Deutschland und desto wütender sind sie auf die Berichterstattung. Die wütenden Reaktionen korrelieren mit einer Zustimmung zu radikalen Protestformen, was wiederum die Beteiligung an den Protestmärschen erhöht. Somit zeigen die Befunde, dass das Misstrauen in die Berichterstattung über PEGIDA auch über deren Anhängerkreis hinaus eng verbunden ist mit erodierendem Vertrauen in Medien und Politik sowie mit der Bereitschaft zu radikalen Protestformen.
Hintergrund: Das System der pflegerischen Versorgung in Deutschland befindet sich in einer Umbruchphase. Seit Jahren wird über eine Weiterentwicklung der Kooperation im Gesundheitswesen und damit über eine Veränderung der Aufgabenverteilung zwischen den Gesundheitsberufen diskutiert. Im Jahr 2008 hat der Gesetzgeber die Einführung von Modellvorhaben zur Übertragung von Heilkunde auf Pflegende gem. § 63 Abs. 3c SGB V ermöglicht. Die Umsetzung verläuft sehr schleppend. Das Ziel der Untersuchung war, die Gründe für diese schleppende Umsetzung aus Sicht der gesetzlichen Krankenkassen zu analysieren.
Methode: Quantitative Befragung aller gesetzlichen Krankenkassen (n=124) in Deutschland.
Ergebnisse: Zur Sicherstellung der Versorgung halten 94 % der Krankenkassen die Übertragung von Heilkunde auf nichtärztliche Leistungserbringer für einen sinnvollen Ansatz. Sie wird von 96 % der Krankenkassen als sehr wichtig empfunden. Zwar befürworten 96 % der Krankenkassen grundsätzlich die Durchführung von Modellvorhaben, tatsächlich sind aber nur 8 % an derartigen Verträgen beteiligt; 71 % der Krankenkassen planen auch keine eigenen Modellvorhaben für die Zukunft.
Als mögliche Ursachen für die bislang schleppende Umsetzung werden aus Sicht der GKV insbesondere rechtliche Hürden (90 %), Widerstand durch ärztliche Standesvertreter (84 %), ungeklärte Finanzierungs- (74 %) und Haftungsfragen (70 %) sowie nicht-praxistaugliche Regelungen in der G-BA-Richtlinie (79 %) und im Gesetz (85 %) angeführt. Weniger als die Hälfte (46 %) der Krankenkassen vermutet hohe Kosten als Ursache für die schleppende Umsetzung.
Diskussion: Die vom Gesetzgeber im aktuellen Pflegeberufereformgesetz (PflBRefG) vorgenommenen Änderungen, insbesondere die Tatsache, dass Krankenkassen entsprechende Modellvorhaben bis zum 31. Dezember 2020 vereinbaren und durchführen sollen, sind vor dem Hintergrund der geäußerten Kritik als zielführend und adäquat zu bezeichnen.
Background: Depletion of ovarian hormone in postmenopausal women has been associated with changes in the locomotor apparatus that may compromise walking function including muscle atrophy/weakness, weight gain, and bone demineralization. Therefore, handgrip strength (HGS), bone mineral density (BMD) and body composition [percentage body fat mass (%BFM), fat mass (FM), Fat-free mass (FFM) and body mass index (BMI)], may significantly vary and predict WB in postmenopausal women. Consequently, the study sought to 1. Explore body composition, BMD and muscle strength differences between premenopausal and postmenopausal women and 2. Explore how these variables [I.e., body composition, BMD and muscle strength] relate to WB in postmenopausal women.
Method: Fifty-one pre-menopausal (35.74 + 1.52) and 50 postmenopausal (53.32 + 2.28) women were selected by convenience sampling and studied. Six explanatory variables (HGS, BMD, %BFM, FFM, BMI and FM) were explored to predict WB in postmenopausal women: Data collected were analyzed using multiple linear regression, ANCOVA, independent t-test and Pearson correlation coefficient at p < 0.05.
Result: Postmenopausal women had higher BMI(t = + 1.72; p = 0.04), %BFM(t = + 2.77; p = .003), FM(t = + 1.77; p = 0.04) and lower HGS(t = − 3.05; p = 0.001),compared to the premenopausal women. The predicted main effect of age on HGS was not significant, F(1, 197) = 0.03, p = 0.06, likewise the interaction between age and %BFM, F(1, 197) = 0.02, p = 0.89; unlike the predicted main effect of %BFM, F(1, 197) = 10.34, p = .002, on HGS. HGS was the highest predictor of WB (t = 2.203; β=0.3046) in postmenopausal women and combined with T-score right big toe (Tscorert) to produce R2 = 0.11;F (2, 47)=4.11;p = 0.02 as the best fit for the predictive model. The variance (R2) change was significant from HGS model (R2 = 0.09;p = 0.03) to HGS + Tscorert model (R2 = 0.11;p = 0.02). The regression model equation was therefore given as: WB =5.4805 + 0.1578(HGS) + (− 1.3532) Tscorert.
Conclusion: There are differences in body composition suggesting re-compartmentalization of the body, which may adversely impact the (HGS) muscle strength in postmenopausal women. Muscle strength and BMD areassociated with WB, although, only contribute to a marginal amount of the variance for WB. Therefore, other factors in addition to musculoskeletal health are necessary to mitigate fall risk in postmenopausal women.
Toward a service-based workflow for automated information extraction from herbarium specimens
(2018)
Over the past years, herbarium collections worldwide have started to digitize millions of specimens on an industrial scale. Although the imaging costs are steadily falling, capturing the accompanying label information is still predominantly done manually and develops into the principal cost factor. In order to streamline the process of capturing herbarium specimen metadata, we specified a formal extensible workflow integrating a wide range of automated specimen image analysis services. We implemented the workflow on the basis of OpenRefine together with a plugin for handling service calls and responses. The evolving system presently covers the generation of optical character recognition (OCR) from specimen images, the identification of regions of interest in images and the extraction of meaningful information items from OCR. These implementations were developed as part of the Deutsche Forschungsgemeinschaft funded a standardised and optimised process for data acquisition from digital images of herbarium specimens (StanDAP-Herb) Project.
Staphylococcus aureus is recognized worldwide as one of the major agents of dairy cow intra-mammary infections. This microorganism can express a wide spectrum of pathogenic factors used to attach, colonize, invade and infect the host. The present study evaluated 120 isolates from eight different countries that were genotyped by RS-PCR and investigated for 26 different virulence factors to increase the knowledge on the circulating genetic lineages among the cow population with mastitis. New genotypes were observed for South African strains while for all the other countries new variants of existing genotypes were detected. For each country, a specific genotypic pattern was found. Among the virulence factors, fmtB, cna, clfA and leucocidins genes were the most frequent. The sea and sei genes were present in seven out of eight countries; seh showed high frequency in South American countries (Brazil, Colombia, Argentina), while sel was harboured especially in one Mediterranean country (Tunisia). The etb, seb and see genes were not detected in any of the isolates, while only two isolates were MRSA (Germany and Italy) confirming the low diffusion of methicillin resistance microorganism among bovine mastitis isolates. This work demonstrated the wide variety of S. aureus genotypes found in dairy cattle worldwide. This condition suggests that considering the region of interest might help to formulate strategies for reducing the infection spreading.
Background: Concerns about practice of self-medication (SM) world across are based on associated risks such as adverse reactions, disease masking, increased morbidity, wastage of resources and antibiotic resistance. SM is likely to differ between rural and urban areas of India. Systematically retrieved evidence on these differences are required in order to design targeted measures for improvement. Methods: We conducted a cross sectional study among the general population in urban (Matunga) and rural (Tala) areas of Maharashtra, India to explore SM practices and its associated factors. Face to face interviews were conducted using the validated study questionnaire. Data was analyzed by using descriptive and analytical statistical methods. Results: A total of 1523 inhabitants from 462 households were interviewed between [June/2015] and [August /2015], 778 (51%) of them in rural and 745 (49%) in urban areas. Overall self-medication prevalence was 29.1% (urban; 51.5%, rural; 7.7%, OR 12.7, CI 9.4-17.2) in the study participants. Participants having chronic disease (OR: 3.15, CI: 2.07-4.79) and from urban areas (OR:15.38, CI:8.49-27.85) were more likely to self-medicate. Self-medication practices were characterized by having old prescription (41.6%) as the main reason, fever (39.4%) as top indication and NSAIDs (Non-Steroidal Anti Inflammatory Agents) as the most self-medicated category of drugs (40.7%). Conclusions: The present study documented that the prevalence of self-medication is associated with place of residence, and health status of the study participants. Self-medication is still a major issue in western Maharashtra, India and is majorly an urban phenomenon. Status of implementation of existing regulations should be reconsidered.
Research question: In order to reduce fan aggression surrounding rivalry games, team sport organizations often try to placate fans by downplaying the importance of the game (e.g. ‘the derby is not a war’). Drawing on the intergroup conflict literature, this research derives dual identity statements and examines their effectiveness in reducing fan aggressiveness compared to the managerial practice of downplaying rivalry.
Research methods: Three field experimental studies (one face-to-face survey and two online surveys) tested the hypotheses. Established rivalries in the German soccer league Bundesliga served as the empirical setting of the studies. The data were analyzed using ANCOVA and linear regression analyses.
Results and findings: Dual identity statements reduce fan aggressiveness compared to both downplay statements and a no-statement control condition, independent of team identification and trait aggression. Importantly, the managerial practice of downplaying rivalry appears to be counterproductive. It produces even higher levels of fan aggressiveness than making no statement, an effect caused by psychological reactance.
Implications: Sport organizations should not alienate their fan base by attempting to play down the importance of rivalry, which is an integral part of fan identity. Instead, they should strengthen the supporters’ unique identity (as fans of a particular team) while at the same time facilitating identification with the rival at a superordinate level (e.g. as joint fans of a region).
Medical devices are health care products distinguished from drugs for regulatory purposes in most countries based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to accomplish their primary intended effect. Developing new medical devices requires clinical investigations and approval process goes through similar process like drugs. Medical device approvals in the period of 2010 to 2014 were searched from USFDA website. Disease burden data in the similar period was searched from centers for disease control and prevention website. Collected data was analyzed to know number of approved devices, top therapy areas, and mechanism of action of these devices. Out of a total of 200 medical devices approvals in the time period of 2010 to 2014, maximum number of devices (51; 25.5%) were approved in the year 2011, cardiovascular (78; 39%) was the top therapy area. Highest number (180; 90%) of approved medical devices belonged to the category III and maximum number (73; 36.5%) of approved medical devices had ―mechanical‖ mechanism of action. The top 3 causes of deaths in USA during 2010 to 2014 were heart disease, cancer and followed by respiratory infection. There was a match between the top diseases and the medical device approvals for top 2 diseases in USA i.e. heart disease, and cancer. With respect to respiratory infections and ailments which was the 3rd leading cause of death only one device was approved out of 200 approvals in total.
Objective
We aimed to investigate the proportion of young patients not returning to work (NRTW) at 1 year after ischemic stroke (IS) and during follow-up, and clinical factors associated with NRTW.
Methods
Patients from the Helsinki Young Stroke Registry with an IS occurring in the years 1994–2007, who were at paid employment within 1 year before IS, and with NIH Stroke Scale score ≤15 points at hospital discharge, were included. Data on periods of payment came from the Finnish Centre for Pensions, and death data from Statistics Finland. Multivariate logistic regression analyses assessed factors associated with NRTW 1 year after IS, and lasagna plots visualized the proportion of patients returning to work over time.
Results
We included a total of 769 patients, of whom 289 (37.6%) were not working at 1 year, 323 (42.0%) at 2 years, and 361 (46.9%) at 5 years from IS. When adjusted for age, sex, socioeconomic status, and NIH Stroke Scale score at admission, factors associated with NRTW at 1 year after IS were large anterior strokes, strokes caused by large artery atherosclerosis, high-risk sources of cardioembolism, and rare causes other than dissection compared with undetermined cause, moderate to severe aphasia vs no aphasia, mild and moderate to severe limb paresis vs no paresis, and moderate to severe visual field deficit vs no deficit.
Conclusions
NRTW is a frequent adverse outcome after IS in young adults with mild to moderate IS. Clinical variables available during acute hospitalization may allow prediction of NRTW.
Background
Uncomplicated urinary tract infections (UTI) are common in general practice and usually treated with antibiotics. This contributes to increasing resistance rates of uropathogenic bacteria. A previous trial showed a reduction of antibiotic use in women with UTI by initial symptomatic treatment with ibuprofen. However, this treatment strategy is not suitable for all women equally. Arctostaphylos uva-ursi (UU, bearberry extract arbutin) is a potential alternative treatment. This study aims at investigating whether an initial treatment with UU in women with UTI can reduce antibiotic use without significantly increasing the symptom burden or rate of complications.
Methods
This is a double-blind, randomized, and controlled comparative effectiveness trial. Women between 18 and 75 years with suspected UTI and at least two of the symptoms dysuria, urgency, frequency or lower abdominal pain will be assessed for eligibility in general practice and enrolled into the trial. Participants will receive either a defined daily dose of 3 × 2 arbutin 105 mg for 5 days (intervention) or fosfomycin 3 g once (control). Antibiotic therapy will be provided in the intervention group only if needed, i.e. for women with worsening or persistent symptoms. Two co-primary outcomes are the number of all antibiotic courses regardless of the medical indication from day 0–28, and the symptom burden, defined as a weighted sum of the daily total symptom scores from day 0–7. The trial result is considered positive if superiority of initial treatment with UU is demonstrated with reference to the co-primary outcome number of antibiotic courses and non-inferiority of initial treatment with UU with reference to the co-primary outcome symptom burden.
Discussion
The trial’s aim is to investigate whether initial treatment with UU is a safe and effective alternative treatment strategy in women with UTI. In that case, the results might change the existing treatment strategy in general practice by promoting delayed prescription of antibiotics and a reduction of antibiotic use in primary care.