RepoMed (Medizinische Hochschule Hannover)
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Social Inequalities in Loneliness: disentangling the Contributions of Education, Income, and Occupation
No full textLoneliness represents a serious health risk. However, studies investigating social inequalities in loneliness are rare. Thus, the current study investigates which socioeconomic groups are the most affected by loneliness. Data from the population-based German Aging Survey were used (N= 3,784), with participants being 40+ years old. Education, income, and occupational prestige were used as socioeconomic indicators. It was found that loneliness scores were descriptively higher in groups with lower educational attainment, lower income and lower occupational prestige. In a linear regression analysis, significant socioeconomic differences in loneliness emerged only for income and occupational prestige. Thus, individuals with a low occupational position and those with low income are systematically more affected by loneliness than higher status groups. Material and occupational resources are likely to constitute major socio-structural explanatory variables for loneliness and should be further investigated as such by future studies
Web-Based Development of Standard Operating Procedures and Midwifery Trainings at Ugandan Birth Clinic in the Framework of Implementing a Quality Improvement System for the MEWU—Midwife Exchange with Uganda
No full textAbstract Introduction: High maternal and newborn mortality rates in Sub-Saharan Africa indicate the need for global action interventions. Thus, the clinic cooperation midwife exchange with Uganda (MEWU) between Hannover Medical School and Mutolere Hospital, Uganda, was founded. This study, as the first intervention within the MEWU framework, explored whether a web-based approach is suitable for developing, training, and establishing standard operating procedures (SOPs) at Mutolere Hospital. We focused on assessing midwives’ confidence in midwifery core competencies. Methods: The study was conducted in a prospective, non-controlled intervention design. As a quality improvement tool, the Plan, Do, Check, Act cycle was implemented. SOPs for standard obstetric care were developed and trained in online meetings. Qualitative and quantitative data were collected through a questionnaire completed pre- and post-intervention by participating midwives, evaluations, minutes and video recordings of each case training, and annual analytical reports from Mutolere Hospital containing morbidity and mortality data. Results: The online intervention was successfully implemented. Nine SOPs on basic obstetric care were developed, trained in online case training, and integrated into clinical practice at Mutolere Hospital. An increase in midwives’ confidence regarding all surveyed core competencies was observed. There were no significant changes in the hospital’s morbidity and mortality rates. The quality management system was implemented to optimize the follow-up projects further
Entschlüsselung der funktionellen Rolle der Mesenteriallymphknoten und deren Stromazellen während entzündlicher Darmerkrankungen
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Bewertung der ambulanten ärztlichen Schmerztherapie in Deutschland: Ergebnisse einer internetbasierten Querschnittsbefragung unter ambulant tätigen Schmerzmedizinern
No full textDoes Intraoperative Extracochlear Electrocochleography Correlate With Postoperative Audiometric Hearing Thresholds in Cochlear Implant Surgery? A Retrospective Analysis of Cochlear Monitoring
No full textIn recent years, tools for early detection of irreversible trauma to the basilar membrane during hearing preservation cochlear implant (CI) surgery were established in several clinics. A link with the degree of postoperative hearing preservation in patients was investigated, but patient populations were usually small. Therefore, this study's aim was to analyze data from intraoperative extracochlear electrocochleography (ECochG) recordings for a larger group.During hearing preservation CI surgery, extracochlear recordings were made before, during, and after CI electrode insertion using a cotton wick electrode placed at the promontory. Before and after insertion, amplitudes and stimulus response thresholds were recorded at 250, 500, and 1000 Hz. During insertion, response amplitudes were recorded at one frequency and one stimulus level. Data from 121 patient ears were analyzed.The key benefit of extracochlear recordings is that they can be performed before, during, and after CI electrode insertion. However, extracochlear ECochG threshold changes before and after CI insertion were relatively small and did not independently correlate well with hearing preservation, although at 250 Hz they added some significant information. Some tendencies-although no significant relationships-were detected between amplitude behavior and hearing preservation. Rising amplitudes seem favorable and falling amplitudes disadvantageous, but constant amplitudes do not appear to allow stringent predictions.Extracochlear ECochG measurements seem to only partially realize expected benefits. The questions now are: do gains justify the effort, and do other procedures or possible combinations lead to greater benefits for patients
