OOPS - Oldenburger Online-Publikations-Server (Univ. Oldenburg)
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Cost-effectiveness of a specialist palliative care nurse-patient consultation followed by an interprofessional case conference for patients with non-oncological palliative care needs: results of the KOPAL trial
Get PDFDiffusion-based time series imputation and forecasting with structured atate apace models
No full textThe imputation of missing values represents a significant obstacle for many real-world data analysis pipelines. Here, we focus on time series data and put forward SSSD, an imputation model that relies on two emerging technologies, (conditional) diffusion models as state-ofthe-art generative models and structured state space models as internal model architecture, which are particularly suited to capture long-term dependencies in time series data. We demonstrate that SSSD matches or even exceeds state-of-the-art probabilistic imputation and forecasting performance on a broad range of data sets and different missingness scenarios, including the challenging blackout-missing scenarios, where prior approaches failed to provide meaningful results
Socioeconomic and risk-related drivers of compliance with measures to prevent SARS-CoV-2 infection: evidence from the Munich-based KoCo19 study
No full textObjectives: Although a growing share of the population in many countries has been vaccinated against the SARS-CoV-2 virus to different degrees, social distancing and hygienic non-pharmaceutical interventions still play a substantial role in containing the pandemic. The goal of this study was to investigate which factors are correlated with a higher compliance with these regulations in the context of a cohort study in the city of Munich, southern Germany, during the summer of 2020, i.e. after the first lockdown phase.
Methods: Using self-reported compliance with six regulations and personal hygiene rules (washing hands, avoiding touching face, wearing a mask, keeping distance, avoiding social gatherings, avoiding public spaces) we extracted two compliance factor scores, namely compliance with personal hygiene measures and compliance with social distancing regulations. Using linear and logistic regressions, we estimated the correlation of several socio-demographic and risk perception variables with both compliance scores.
Results: Risk aversion proved to be a consistent and significant driver of compliance across all compliance behaviors. Furthermore, being female, being retired and having a migration background were positively associated with compliance with personal hygiene regulations, whereas older age was related with a higher compliance with social distancing regulations. Generally, socioeconomic characteristics were not related with compliance, except for education, which was negatively related with compliance with personal hygiene measures.
Conclusions: Our results suggest that for a targeted approach to improve compliance with measures to prevent SARS-CoV-2 infection, special attention should be given to younger, male and risk-prone individuals
Improving one-dimensional electro-acoustic models of the ear - applications to young infant’s middle ear screening and to feedback cancellation in hearing aids
Get PDFIn dieser Arbeit werden eindimensionale elektroakustische Modelle des Ohres genutzt um Verbesse-rungen in zwei verschiedenen Anwendungen, dem Mittelohr-Screening bei Säuglingen und der adapti-ven Rückkopplungsauslöschung in Hörgeräten, zu erzielen. Für das Mittelohr-Screening wird ein auf Säug-linge angepasstes Modell von Gehörgang und Mittelohr vorgestellt. Dieses Modell wird genutzt um die Einflüsse von physiologischen Eigenschaften des Ohres und häufigen pathologischen Mittelohrzuständen auf im Gehörgang messbare akustische Immittanzgrößen zu untersuchen. Für die adaptive Rückkopp-lungsauslöschung wird ein Ansatz, der auf einer positionsbasierten Betrachtung des akustischen Rück-kopplungspfades beruht, vorgestellt. Vor- und Nachteile dieses Ansatzes gegenüber einem klassischen positionsunabhängigen Ansatz werden mit Hilfe gemessener Rückkopplungspfade aufgezeigt und disku-tiert
Die Bedeutung von Bildung für nachhaltige Entwicklung in Forschung zu nachhaltiger Entwicklung: ein Diamant, der noch geschliffen werden will
Get PDFDie Dissertation untersucht die Bedeutung von Bildung für nachhaltige Entwicklung (BNE) in Forschung zu nachhaltiger Entwicklung. Durch eine qualitative Analyse von Dokumenten der Forschungsförderung und Expert*inneninterviews in der Forschungspraxis werden die komplexen Zusammenhänge zwischen BNE und Forschung zu nachhaltiger Entwicklung rekonstruiert sowie die beiden Bereiche durch die Entwicklung einer gegenstandsverankerten Grounded Theory systematisch miteinander verknüpft. Im Ergebnis lassen sich vor dem Hintergrund einer Transformativen Wissenschaft Synergieeffekte zwischen Bildung und Forschung für eine nachhaltige Entwicklung durch die integrierte Theorie zu „Partizipativen Lernprozessen“ aufzeigen und die Verankerung von BNE in Forschung zu nachhaltiger Entwicklung fördern
Physical exercise for people with Parkinson’s disease: a systematic review and network meta-analysis
No full textBackground: Physical exercise is effective in managing Parkinson's disease (PD), but the relative benefit of different exercise types remains unclear.
Objectives: To compare the effects of different types of physical exercise in adults with PD on the severity of motor signs, quality of life (QoL), and the occurrence of adverse events, and to generate a clinically meaningful treatment ranking using network meta-analyses (NMAs).
Search methods: An experienced information specialist performed a systematic search for relevant articles in CENTRAL, MEDLINE, Embase, and five other databases to 17 May 2021. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date.
Selection criteria: We included randomized controlled trials (RCTs) comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both.
Data collection and analysis: Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 (RoB 2) tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL. We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach.
Main results: We included 156 RCTs with a total of 7939 participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small (mean 51, range from 10 to 474). The NMAs on the severity of motor signs and QoL included data from 71 (3196 participants), and 55 (3283 participants) trials, respectively. Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group. The effects on the severity of motor signs and QoL are expressed as scores on the motor scale of the Unified Parkinson Disease Rating Scale (UPDRS-M) and the Parkinson's Disease Questionnaire 39 (PDQ-39), respectively. For both scales, higher scores denote higher symptom burden. Therefore, negative estimates reflect improvement (minimum clinically important difference: -2.5 for UPDRS-M and -4.72 for PDQ-39). Severity of motor signs The evidence from the NMA (71 studies; 3196 participants) suggests that dance has a moderate beneficial effect on the severity of motor signs (mean difference (MD) -10.32, 95% confidence interval (CI) -15.54 to -4.96; high confidence), and aqua-based, gait/balance/functional, and multi-domain training might have a moderate beneficial effect on the severity of motor signs (aqua-based: MD -7.77, 95% CI -13.27 to -2.28; gait/balance/functional: MD -7.37, 95% CI -11.39 to -3.35; multi-domain: MD -6.97, 95% CI -10.32 to -3.62; low confidence). The evidence also suggests that mind-body training and endurance training might have a small beneficial effect on the severity of motor signs (mind-body: MD -6.57, 95% CI -10.18 to -2.81; endurance: MD -6.43, 95% CI -10.72 to -2.28; low confidence). Flexibility training might have a trivial or no effect on the severity of motor signs (MD 2.01, 95% CI -4.82 to 8.98; low confidence). The evidence is very uncertain about the effects of strength/resistance training and "Lee Silverman Voice training BIG" (LSVT BIG) on the severity of motor signs (strength/resistance: MD -6.97, 95% CI -11.93 to -2.01; LSVT BIG: MD -5.49, 95% CI -14.74 to 3.62; very low confidence). Quality of life The evidence from the NMA (55 studies; 3283 participants) suggests that aqua-based training probably has a large beneficial effect on QoL (MD -14.98, 95% CI -23.26 to -6.52; moderate confidence). The evidence also suggests that endurance training might have a moderate beneficial effect, and that gait/balance/functional and multi-domain training might have a small beneficial effect on QoL (endurance: MD -9.16, 95% CI -15.68 to -2.82; gait/balance/functional: MD -5.64, 95% CI -10.04 to -1.23; multi-domain: MD -5.29, 95% CI -9.34 to -1.06; low confidence). The evidence is very uncertain about the effects of mind-body training, gaming, strength/resistance training, dance, LSVT BIG, and flexibility training on QoL (mind-body: MD -8.81, 95% CI -14.62 to -3.00; gaming: MD -7.05, 95% CI -18.50 to 4.41; strength/resistance: MD -6.34, 95% CI -12.33 to -0.35; dance: MD -4.05, 95% CI -11.28 to 3.00; LSVT BIG: MD 2.29, 95% CI -16.03 to 20.44; flexibility: MD 1.23, 95% CI -11.45 to 13.92; very low confidence). Adverse events Only 85 studies (5192 participants) provided some kind of safety data, mostly only for the intervention groups. No adverse events (AEs) occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls (18 studies) and pain (10 studies). The evidence is very uncertain about the effect of physical exercise on the risk of adverse events (very low confidence). Across outcomes, we observed little evidence of differences between exercise types.
Authors' conclusions: We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions. Thus, our review highlights the importance of physical exercise regarding our primary outcomes severity of motor signs and QoL, while the exact exercise type might be secondary. Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD-specific programs. Although the evidence is very uncertain about the effect of exercise on the risk of adverse events, the interventions included in our review were described as relatively safe. Larger, well-conducted studies are needed to increase confidence in the evidence. Additional studies recruiting people with advanced disease severity and cognitive impairment might help extend the generalizability of our findings to a broader range of people with PD
Targeted data quality analysis for a clinical decision support system for SIRS detection in critically ill pediatric patients
No full textIdentifying interactions between determinants of intention for civic engagement against transportation noise exposure: a theory-driven classification tree analysis with cross-sectional data from the KORA study in Germany
No full textThe European Environmental Noise Directive highlights public participation in the development and review of noise action plans. Considering unequal participation opportunities, determinants of public civic engagement are crucial. We conceptualised these determinants to arise from four components: (1) noise exposure, (2) environmental resources, (3) engagement-specific cognitions, and (4) general cognitions and emotions. We aimed to classify intention for civic engagement in a population-based sample from the German KORA study in the Augsburg region by using Conditional Inference Trees (CIT) with variables attributed to the four components (N = 3,743, 43–92 years). The “engagement-specific cognitions”-CIT showed the highest prevalence of civic engagement intention resulting from interactions between subjective norm (expecting positive feedback from significant others), self-efficacy (having confidence to engage), and knowledge of noise abatement planning (70.6% as compared to the sample average (11.2%)). To promote equitable decision-making, participation might benefit from focusing on residents’ cognitive-behavioural processes