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  • 1
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2011
    In:  BMC Health Services Research Vol. 11, No. 1 ( 2011-12)
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2011-12)
    Abstract: New therapeutic strategies in muscular dystrophies will make a difference in prognosis only if they are begun early in the course of the disease. Therefore, we investigated factors that influence the time to diagnosis in muscle dystrophy patients. Methods A sample of 101 patients (mean age 49 years; range 19-80; 44% women) with diagnosed muscle dystrophies from neurological practices and the neuromuscular specialty clinic in Berlin, Germany, was invited to participate. Time from first consultation to diagnosis, subspecialty of physician, and sociodemographic data were assessed with self-report questionnaires. The association between time to diagnosis and potential predictors (subspecialty of initially consulted physician, diagnoses, gender, and age at onset) was modeled with linear regression analysis. Results The mean time span between first health-care contact and diagnosis was 4.3 years (median 1). The diagnostic delay was significantly longer if patients were initially seen by a non-neurological specialist compared to a general practitioner (5.2 vs. 3.5 years, p = 0.047). Other factors that were independently associated with diagnostic delay were female gender and inherited muscle disease. Conclusion Action to improve clinical awareness of muscle diseases in non-neurological specialists is needed.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2011
    detail.hit.zdb_id: 2050434-2
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  • 2
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: While the relation between care involvement of informal caregivers and caregiver burden is well-known, the additional psychosocial burden related to care involvement during the COVID-19 pandemic has not yet been investigated. Methods A total of 1000 informal caregivers, recruited offline, participated in a cross-sectional online survey from April 21 to May 2, 2020. Questionnaires were used to assess COVID-19-specific changes in the care situation, negative feelings in the care situation, problems with implementation of COVID-19 measures, concerns/excessive demands, loss of support, change in informal caregivers’ own involvement in care and problems with provision, comprehension & practicability of COVID-19 information, and to relate these issues to five indicators of care involvement (i.e., being the main caregiver, high expenditure of time, high level of care, dementia, no professional help). Binomial and multiple regression analyses were applied. Results Across indicators of care involvement, 25.5–39.7% reported that the care situation rather or greatly worsened during the COVID-19 pandemic, especially for those caring for someone with dementia or those usually relying on professional help. In a multiple regression model, the mean number of involvement indicators met was associated with age (β = .18; CI .10–.25), excessive demands (β = .10, CI .00–.19), problems with implementation of COVID-19 measures (β = .11, CI .04–.19), an increase in caregiving by the informal caregivers themselves (β = .14, CI .03–.24) as well as with no change in the amount of caregiving (β = .18, CI .07–.29) and loss of support (β = −.08, CI −.16–.00). No significant associations with the mean number of involvement indicators met were found for gender, educational level, change in the care situation, negative feelings, and provision, comprehension & practicability of COVID-19 information. Conclusion Those caregivers who perceived extensive care burden were those who suffered most during the pandemic, calling for structural support by the healthcare system now and in the future. Trial registration This article does not report the results of a health care intervention on human participants.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 3
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrant further investigation. Methods We used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N  = 12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor). Results In 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18–25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55–64 OR 1.02, 65–74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model. Conclusion There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 4
    In: Journal of Alzheimer's Disease, IOS Press, Vol. 68, No. 2 ( 2019-03-29), p. 745-755
    Type of Medium: Online Resource
    ISSN: 1387-2877 , 1875-8908
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2019
    detail.hit.zdb_id: 2070772-1
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  • 5
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2008
    In:  Public Health Forum Vol. 16, No. 1 ( 2008-4-1), p. 2-4
    In: Public Health Forum, Walter de Gruyter GmbH, Vol. 16, No. 1 ( 2008-4-1), p. 2-4
    Type of Medium: Online Resource
    ISSN: 1876-4851 , 0944-5587
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2008
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  • 6
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  ProCare Vol. 27, No. 10 ( 2022-12), p. 8-10
    In: ProCare, Springer Science and Business Media LLC, Vol. 27, No. 10 ( 2022-12), p. 8-10
    Type of Medium: Online Resource
    ISSN: 0949-7323 , 1613-7574
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2479746-7
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2010
    In:  European Journal of Ageing Vol. 7, No. 3 ( 2010-9), p. 201-211
    In: European Journal of Ageing, Springer Science and Business Media LLC, Vol. 7, No. 3 ( 2010-9), p. 201-211
    Type of Medium: Online Resource
    ISSN: 1613-9372 , 1613-9380
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2010
    detail.hit.zdb_id: 2169429-1
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  • 8
    Online Resource
    Online Resource
    JMIR Publications Inc. ; 2017
    In:  Journal of Medical Internet Research Vol. 19, No. 4 ( 2017-04-05), p. e101-
    In: Journal of Medical Internet Research, JMIR Publications Inc., Vol. 19, No. 4 ( 2017-04-05), p. e101-
    Type of Medium: Online Resource
    ISSN: 1438-8871
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2017
    detail.hit.zdb_id: 2028830-X
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  • 9
    In: Pflege, Hogrefe Publishing Group, Vol. 35, No. 3 ( 2022-06-01), p. 133-142
    Abstract: Zusammenfassung. Hintergrund: Das Spannungsfeld zwischen Gesundheitsschutz und Einschränkungen des sozialen Lebens in den Pflegeheimen während der Pandemie ist unzureichend aufgearbeitet. Ziel: Ziel war es, bundesländerspezifische Verordnungen zu systematisieren und die Umsetzungen dieser in einen Zusammenhang mit Einschränkungen sozialer Angebote für die Bewohner_innen zu bringen. Methoden: In einem Mixed-Methods-Design wurden Schutzmaßnahmen für Pflegeheime in der ersten Pandemiewelle aus 450 Verordnungen kategorisiert, in ein theoretisches Maßnahmenmodell eingespeist und in einem Survey unter Heimleitungen (n = 1260) zur Handhabung der Maßnahmen sowie zum Wegfall sozialer Angebote verwendet. Der Zusammenhang von Schutzmaßnahmen und Einschränkungen sozialer Angebote wurde mit binärlogistischen verallgemeinerten Schätzgleichungen analysiert. Ergebnisse: Die Verordnungen konnten in fünf Themen kategorisiert werden. Die Daten zeigen, dass „Besuchsverbote“ (98,3 %) und „Körperkontaktreduzierung“ (90,5 %) den größten Teil der Einschränkungen darstellen. Über alle Angebote hinweg waren „Verbotsmaßnahmen“ und für viele Angebote „Kontaktreduzierungen“ bedeutsam assoziiert, während etwa der Wegfall von „Gruppenangeboten“ zweimal so hoch war, wenn die Schutzmaßnahme „Reduzierung des Körperkontaktes“ umgesetzt wurde. „Besuchseinschränkungen“ zeigten kaum signifikante Assoziationen. Schlussfolgerungen: Die Ergebnisse belegen einen Zusammenhang von Schutzmaßnahmen und Wegfall sozialer Angebote. Maßnahmen, die den Gesundheitsschutz mit dem Erhalt von sozialen Angeboten und Versorgung kombinieren, sollten priorisiert werden.
    Type of Medium: Online Resource
    ISSN: 1012-5302 , 1664-283X
    RVK:
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2022
    detail.hit.zdb_id: 2077531-3
    detail.hit.zdb_id: 645005-2
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  BMC Medical Education Vol. 23, No. 1 ( 2023-08-11)
    In: BMC Medical Education, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-08-11)
    Abstract: Diagnostic accuracy is one of the major cornerstones of appropriate and successful medical decision-making. Clinical decision support systems (CDSSs) have recently been used to facilitate physician’s diagnostic considerations. However, to date, little is known about the potential assets of CDSS for medical students in an educational setting. The purpose of our study was to explore the usefulness of CDSSs for medical students assessing their diagnostic performances and the influence of such software on students’ trust in their own diagnostic abilities. Methods Based on paper cases students had to diagnose two different patients using a CDSS and conventional methods such as e.g. textbooks, respectively. Both patients had a common disease, in one setting the clinical presentation was a typical one (tonsillitis), in the other setting (pulmonary embolism), however, the patient presented atypically. We used a 2x2x2 between- and within-subjects cluster-randomised controlled trial to assess the diagnostic accuracy in medical students, also by changing the order of the used resources (CDSS first or second). Results Medical students in their 4 th and 5 th year performed equally well using conventional methods or the CDSS across the two cases ( t (164) = 1,30; p  = 0.197). Diagnostic accuracy and trust in the correct diagnosis were higher in the typical presentation condition than in the atypical presentation condition ( t (85) = 19.97; p   〈  .0001 and t (150) = 7.67; p   〈  .0001).These results refute our main hypothesis that students diagnose more accurately when using conventional methods compared to the CDSS. Conclusions Medical students in their 4 th and 5 th year performed equally well in diagnosing two cases of common diseases with typical or atypical clinical presentations using conventional methods or a CDSS. Students were proficient in diagnosing a common disease with a typical presentation but underestimated their own factual knowledge in this scenario. Also, students were aware of their own diagnostic limitations when presented with a challenging case with an atypical presentation for which the use of a CDSS seemingly provided no additional insights.
    Type of Medium: Online Resource
    ISSN: 1472-6920
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2044473-4
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