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Effects of individualized and general self-regulation online training on teachers' self-regulation, well-being and stress
No full textThis repository contains supplementary information as well as data files that are needed to reproduce the results of the following publication: Li Sanchez K, Schwinger M. Effects of individualized and general self-regulation online training on teachers' self-regulation, well-being and stress. (in prep.)
This study investigates the effects of a brief individualized vs. general self-regulation online training on teachers' self-regulation competence, well-being, and stress levels. Self-regulation competence was assessed in a sample of german teachers at three time points using the MSR-T (Li Sanchez &Schwinger, 2023). Teachers were assigned to either individualized self-regulation training, general self-regulation training, or a waitlist control group. In addition to self-regulation competence, well-being was measured using the WHO-5 Well-Being Index (Bech, 2004), general stress was assessed using the Perceived Stress Scale PSS-10 (german version, Klein et al, 2016) and occupational stress was measured using the Occupational Stress Scale (Enzmann & Kleiber, 1989). Mixed ANOVA and linear regression analyses revealed, that self-regulation could be fostered through our individualized training and that teachers with low baseline competences in particular benefited from the training. Facets of self-regulation were shown to be significant predictors of well-being and general as well as occupational stress.
The used data are provided as sav and csv, further this repository contains sample tasks from the teacher training.
For further information see readme.txtGerman Federal Ministry of Education and ResearchV
Integrating Affective Responses into Game Theory: A Dual Selves Model
No full textThis paper develops a method to integrate affective reponses into game theoretical models. We illustrate our method in a team production framework. The model analyzes how concave and convex status preferences for esteem solve the problem of team production under complete and incomplete information about workers’ abilities. Using a dual selves model, we model the choice of effort as a deliberative decision and the expression of esteem as an affective response. Modeling an individual’s affective system as a seperate player allows us to apply standard game-theoretic solution concepts to analyze affective responses
On Shadow Banking and Financial Frictions in DSGE Modeling
No full textAt the forefront of macroeconomic research on the causes of the Great Financial Crisis (GFC) was and still is the usage of dynamic stochastic general equilibrium (DSGE) models. To capture the nonlinearities of the GFC, these models were enriched with a variety of .financial frictions. This paper focuses on a special subset of these frictions, the shadow banking system. We provide a structured review of the strand of literature that considers shadow banking in DSGE setups and draw particular attention to the modeling approach as well as impact of shadow banking. Our analysis allows the following conclusions: firstly, models featuring shadow banking are better able to simulate realistic movements in the business cycle that are of comparable magnitude to the GFC. Secondly, the models consider amplification channels between the financial sector and the real economy that proved to be of importance during the crisis. Thirdly, the models display a good explanatory power of .financial stability measures in the light of shadow banking
Dissecting the role of toll-like receptor 7 in pancreatic cancer
No full textToll-like receptors (TLRs) are gaining attention for their potential to influence tumor biology both on the level of the tumor cells as well as on the level of the surrounding inflammatory stroma. Previous studies resulted in partly conflicting data on the expression of TLR7 in healthy and neoplastic pancreatic tissues as well as its role in pancreatic tumor biology.
We used qRT-PCR and immunohistochemistry to asses TLR7 expression in primary patient material and cell lines. Cell viability was analyzed by MTT assay upon incubation with TLR7 agonist/antagonist. Mouse models were used to investigate the role of TLR7 in vivo.
TLR7 is overexpressed in more than 50% of primary human pancreatic ductal adenocarcinoma (PDAC). High TLR7 expression was associated with shorter patient survival, and TLR7 inhibition in cell lines reduced viability in a dose-dependent manner. In contrast, global TLR7 deficiency did not alter survival or overall histopathological tumor features in genetic mouse models of PDAC.
TLR7 may have opposing functions in tumor versus stroma cells. Further work is required to more precisely dissect the roles of TLR7 and its ligands in different populations of epithelial and stromal cells and to understand their relative contributions to tumor progression.Gefördert durch den Open-Access-Publikationsfonds der UB Marburg
Verbesserung der Adhärenz in der medikamentösen Therapie bei Patienten mit Hypercholesterinämie durch die erweiterte pharmazeutische Betreuung in der öffentlichen Apotheke
No full textStatine sind weltweit die am häufigsten angewandten Arzneimittel bei Hypercholesterinämie. Der Erfolg der Therapie mit Statinen ist allerdings durch die schlechte Adhärenz der Patienten eingeschränkt.
In der ADSTAPHARM-Studie (ADhärenz von STAtin-Patienten bei PHARMazeutischer Betreuung) wurden die kurz- und langfristigen Effekte einer einfachen Medikationsanalyse der öffentlichen Apotheke auf die Adhärenz von Statin-Patienten untersucht. Dabei wurden auch die Auswirkungen auf die arzneimittelbezogenen Probleme (ABP) beleuchtet. In die Studie wurden 390 Patienten eingeschlossen, von denen bei 122 Patienten eine einfache Medikationsanalyse durchgeführt wurde. Die übrigen Patienten erhielten entweder postalisch eine individuelle Medikamentenliste (n = 140) oder dienten als Kontrollgruppe (n = 128).
Bei den 122 Patienten, bei denen die Medikationsanalyse durchgeführt wurde, konnte die Anzahl der ABP signifikant um 47% reduziert werden. Das zeigt auf, welche Bedeutung die Medikationsanalyse für die Arzneimitteltherapiesicherheit besitzt und welches Potential die pharmazeutische Betreuung durch die öffentliche Apotheke hat.
Die Adhärenz wurde anhand der Medication Possession Ratio (MPR) über einen Zeitraum von fünf Jahren analysiert. Zu Beginn der Studie war die Adhärenz in allen Kategorien der drei Gruppen niedrig. Die Patienten, die eine Medikationsanalyse erhielten, wiesen eine mediane MPR von 0,48 auf. Die Patienten mit einer Medikamentenliste präsentierten einen Median von 0,57. Für die Kontrollgruppe wurde zum Startzeitpunkt der Studie ein Median von 0,41 gemessen.
Es wurde festgestellt, dass die mediane MPR der Patienten nach der Medikationsanalyse signifikant auf 1,0 anstieg, was auf eine bestmögliche Adhärenz schließen lässt. Die Ergebnisse der ADSTAPHARM-Studie zeigen demnach,, dass die Medikationsanalyse in der öffentlichen Apotheke das Potenzial hat, die Adhärenz von Statin-Patienten zu verbessern und damit die Arzneimitteltherapiesicherheit zu erhöhen.
Es wurde ebenso ein signifikanter Anstieg der medianen MPR nach Erhalt der Medikamentenliste verzeichnet (mediane MPR: 0,86). Daher ist die Annahme plausibel, dass die Medikamentenliste bei diesen Patienten einen Erinnerungscharakter hatte.
Die Kontrollgruppe zeigte signifikante Schwankungen in der MPR. Die mediane MPR stieg beispielsweise von anfänglich 0,41 auf 0,64 zum ersten Beobachtungszeitpunkt. Hervorzuheben ist, dass die mediane MPR der Kontrollgruppe trotz dieser Schwankungen zu allen Beobachtungszeitpunkten unter 0,8 lag und die Patienten der Kontrollgruppe somit nicht den Schwellenwert erreichten, um als adhärent eingestuft zu werden. Darüber hinaus ist anzumerken, dass die MPR der Kontrollgruppe zu allen Beobachtungszeitpunkten mit Ausnahme des Zeitpunkts nach fünf Jahren unter der MPR der beiden Studienpopulationen (Subgruppen, die entweder eine Medikationsanalyse oder eine individuelle Medikamentenliste erhalten) lag.
Alle Kategorien wiesen nach fünf Jahren eine vergleichbare mediane MPR auf, und es wurde kein signifikanter Unterschied in der MPR zwischen dem Ausgangswert und dem Endpunkt in allen Kategorien beobachtet. Das deutet darauf hin, dass die Auswirkungen der Medikationsanalyse und auch der Medikamentenliste nur von kurzer Dauer waren.
Ebenso wurden die Auswirkungen der einfachen Medikationsanalyse auf Patienten mit vs. ohne Polymedikation, Männer vs. Frauen sowie Atorvastatin-Patienten vs. Simvastatin-Patienten betrachtet. Dabei konnte kein signifikanter Unterschied in der Grundadhärenz zwischen den jeweiligen Gruppen festgestellt werden, daher konnten keine Subgruppen ausgemacht werden, die beim Adhärenzmanagement bevorzugt betreut werden sollten. Es konnte aber gezeigt werden, dass die Patienten, die zu Beginn der Studie nicht-adhärent waren, von der einfachen Medikationsanalyse hinsichtlich ihrer Adhärenz profitieren.
Zusammenfassend zeigen die Ergebnisse der ADSTAPHARM-Studie, dass eine einfache Medikationsanalyse in öffentlichen Apotheken eine entscheidende Rolle spielt, die Anzahl der ABP signifikant zu verringern sowie die Adhärenz von Statin-Patienten zu verbessern, wobei diese positiven Effekte zeitlich begrenzt zu sein scheinen.Statins are the most commonly used drugs for hypercholesterolemia worldwide. However, the therapy outcome is limited predominantly due to poor adherence. In the presented ADSTAPHARM study (ADherence of STAtin patients under PHARMaceutical care), the short- and long-term effects of a medication review in the community pharmacy on the adherence of statin patients were investigated. At the same time, the effect of the medication review on drug-related problems (DRP) was analyzed. The ADSTAPHARM study enrolled 390 patients, 122 of whom underwent a medication review. The other patients either received an individual medication list (n = 140) or served as a control group (n = 128).
For the 122 patients, the number of DRP was significantly reduced by 47% after the medication review. A medication review can therefore recognise and, to a large extent, eliminate ABP, thereby contributing to drug therapy safety.
Adherence was analyzed using the Medication Possession Ratio (MPR). It was found that the median MPR of the patients increased significantly to 1.0 after the medication review, indicating optimal adherence. It can therefore be concluded that the medication review has the potential to improve the adherence of statin patients and thus elevate drug therapy safety.
The patients receiving the medication list demonstrated a significant improvement following the receipt of the medication list (median MPR: 0.86). Therefore, it is legitimate to assume that the medication list had a reminder character for the enrolled patients.
The control group showed significant fluctuations in the MPR. The median MPR increased from an initial 0.41 to 0.64 at the first measurement point. It should be emphasized that the median MPR of the control group is below 0.8 at all relevant time points and thus the patients in the control group do not reach the threshold value to be classified as adherent. Furthermore, it should be noted that the median MPR of the control group was below the median MPR of both study populations (subgroups receiving either a medication review or an individual medication list) at all observation time points except for the time point after five years.
All categories showed a comparable MPR after five years and no significant difference in MPR was observed between baseline and endpoint in all categories, indicating that the effects of the medication review and medication list were short-lived.
The effects of the medication review on patients with vs. without polymedication, men vs. women and atorvastatin vs. simvastatin patients were also analyzed. It was shown that there was no significant between-group difference in baseline adherence and in the period directly after the medication review. Accordingly, no subgroups could be identified that should be explicitly focussed on in adherence management in the slope of a medication review. Instead, it was shown that patients who were non-adherent at the start of the study benefited particularly from the medication review in terms of their adherence.
Overall, the results of the ADSTAPHARM study suggest that the medication review in the community pharmacy has the potential to significantly reduce DRP and improve the adherence of statin patients, although the positive effects seem to be limited over time
Strahlentherapie und Palliativmedizin Eine Untersuchung zur interdisziplinären Zusammenarbeit
No full textEinleitung Radioonkologen sind oft in die Palliativversorgung von nicht heilbaren
Krebspatienten involviert. Ziel dieser Arbeit ist die Erfassung der
strahlentherapeutischen Einstellungen, Kompetenzen und des potenziellen
Unterstützungsbedarfs in der palliativmedizinischen Versorgung. Zudem sollen
mögliche Barrieren für die Integration der Palliativmedizin in die Strahlentherapie
identifiziert werden, um die Zusammenarbeit zwischen der Strahlentherapie und der
Palliativmedizin zu verbessern.
Material und Methoden Eine Online-Befragung der ärztlichen DEGRO-Mitglieder wurde
von November 2016 bis Februar 2017 durchgeführt. Der Fragebogen mit 27 Fragen ist
in fünf Abschnitte unterteilt: Einleitung, Qualifikation, Einstellungen, Fort- und
Weiterbildung sowie Demografie. Neben vorgegebenen Antwortmöglichkeiten wie
Multiple Choice und Likert-Skalen wurden offene Fragen integriert. Für den neu
entwickelten Fragebogen sind spezielle Fragen entwickelt und von erfahrenen Kollegen
überprüft sowie präzisiert worden. Die anderen Fragen sind gestützt auf vorherige
Umfragen und wurden, den Zielsetzungen der Arbeit entsprechend, angepasst. Um eine
möglichst hohe Teilnehmerzahl unter Strahlentherapeuten zu erreichen und zugleich
Anonymität zu gewährleisten, wurde für die Datenerhebung ein quantitativer Ansatz in
Form einer webbasierten Umfrage gewählt.
Ergebnisse Von 1.110 Anfragen wurden 205 Fragebögen vollständig beantwortet; dies
entspricht einer Rücklaufquote von 18 Prozent. 51 Prozent der Befragten waren
weiblich, wobei die Altersgruppe 50 Jahre und älter mit 51 Prozent am stärksten
vertreten war. Diese schloss signifikant häufiger Befragte mit der Zusatzbezeichnung
Palliativmedizin ein (89 Prozent vs. 72 Prozent, p = .033). Für 82 Prozent der Befragten
hatte die palliativmedizinische Versorgung einen hohen Stellenwert, 84 Prozent gaben
an, in ihrem beruflichen Alltag häufig die Notwendigkeit palliativmedizinischer
Versorgung zu erleben. 18 Prozent der Befragten berichteten über Schwierigkeiten bei
der Betreuung von Tumorpatienten im Endstadium, insbesondere Strahlentherapeuten
unter 50 Jahren (26/101, 25 Prozent vs. 10/104, 10 Prozent, p = .017). Befragte mit der
Zusatzbezeichnung Palliativmedizin fühlten sich signifikant häufiger sicher in
palliativmedizinischen Fähigkeiten.
Die Hauptfaktoren für den qualifizierenden Erwerb palliativmedizinischer Kompetenzen
waren: die eigene Praxiserfahrung, der Austausch mit Kollegen sowie die Teilnahme an
Seminaren und Fortbildungsveranstaltungen. Die am häufigsten wahrgenommenen
Hindernisse waren: Zeitaspekte, Stigmatisierung, interdisziplinäre Zusammenarbeit,
Unerfahrenheit und Unwissenheit. 42 Prozent der Befragten gaben an, in der
Strahlentherapie mit den Fort- und Weiterbildungsmöglichkeiten in palliativer Medizin
zufrieden zu sein. 39 Prozent der befragten Strahlentherapeuten zeigten sich neutral,
18 Prozent waren nicht zufrieden. Auffällig war, dass signifikant mehr Befragte unter 50
Jahren sich unzufrieden äußerten (20/101, 20 Prozent vs. 14/104, 13 Prozent, p = .023,
Vorhandensein ZPM n.s.).
Als potenzielle Maßnahmen zur Verbesserung der palliativmedizinischen Versorgung in
der Strahlentherapie wurden das Streben nach einer intensiveren Zusammenarbeit mit
palliativmedizinisch ausgebildeten Kollegen, eine frühzeitige Einbindung des
multiprofessionell agierenden palliativmedizinischen Teams und die Integration der
Palliativmedizin in die onkologische Betreuung bereits zum Zeitpunkt der
Diagnosestellung in Betracht gezogen.
Schlussfolgerung Die niedrige Rücklaufquote erlaubte keine umfassenden
Schlussfolgerungen für die Gesamtheit der Strahlentherapeuten. Die Studie verdeutlicht
jedoch den hohen Stellenwert, den die palliativmedizinische Versorgung für die
befragten Strahlentherapeuten einnimmt. Die aufgedeckten Schwierigkeiten im
psychosozialen Bereich sowie existierende Barrieren wie Zeitmangel, Stigmata und
mangelnde interdisziplinäre Zusammenarbeit könnten die adäquate palliative
Versorgung in der Strahlentherapie erschweren und deren erfolgreiche Integration
beeinträchtigen. Die Untersuchung zeigte außerdem, dass erworbene
palliativmedizinische Kenntnisse und Fertigkeiten zu einer markant erhöhten
Zufriedenheit mit den eigenen palliativmedizinischen Kompetenzen und zu häufigeren
Konsultationen von Spezialisten führten. Insbesondere jüngere Strahlentherapeuten
benötigen weitere Unterstützungsangebote und sollten ermutigt werden,
palliativmedizinische Erfahrungen und Kenntnisse zu erwerben. Die Aufnahme
palliativer Lehrveranstaltungen in die Assistenzarztzeit kann die palliative Ausbildung
stärken. Eine vertiefte Auseinandersetzung mit der Palliativmedizin sowie die
Überwindung der identifizierten, vorhandenen Barrieren sind entscheidend für die
erfolgreiche Integration der Palliativmedizin in die Strahlentherapie. Letztendlich kann
die Zusatzausbildung in der Palliativmedizin Ärzte für die Komplexität der
palliativmedizinischen Versorgung sensibilisieren, das palliative Bewusstsein schärfen
und die Integration der Palliativmedizin in die Strahlentherapie weiter vorantreiben.Background Radiation oncologists frequently engage in palliative medical care for
cancer patients with incurable diseases. This study aims to assess the attitudes,
competencies, and potential support needs of radiation oncologists in palliative care,
aiming to strengthen collaboration between radiation therapy and palliative medicine.
Methods A survey was developed for radiation oncologists with the aim of assessing the
current state, limitations, and possibilities for collaboration between radiation therapy
and palliative medicine. The electronic questionnaire covered the following topics: (1)
palliative medical care and treatment in the daily routine of radiation therapists, (2)
collaboration between radiotherapy and palliative medicine, (3) expertise and
challenges of radiation therapists in palliative medical care, (4) attitudes toward
palliative care, and (5) level of education and the need for further education. The survey
instrument, consisting of two items, was designed to collect data on the cooperation
between radiation therapy and palliative medicine, including the current situation of
palliative care in radiation therapy. To enhance the questionnaire, items related to
various aspects of palliative medicine were adapted from a prior survey instrument. A
team of experienced professionals in palliative care supported the conception of the
questionnaire. The survey was conducted electronically using the DEGRO mailing list,
reaching out to physicians (n=1149) employed in the field of radiation therapy in
Germany during the period from November 2016 to December 2016.
Results The survey was successfully emailed to 1110 DEGRO members, with 205
questionnaires eligible for analysis (response rate 18%). Of the respondents, 51% were
female, and the age range of 50 and older was most represented at 51%. Within this age
group, 27% had a specialized qualification in palliative care. For the majority of radiation
oncologists (82%), palliative medical care was deemed highly important, with 84%
expressing a frequent need for palliative care in their everyday professional life. While
a significant number (37%) either strongly agreed or agreed that every radiation
oncologist should have basic competences in palliative care, only a minority (37%)
consulted a colleague in palliative treatment decisions. Half of the respondents (50%)
reported frequent involvement of palliative care through consultancy services.
Physicians with dual board certification in palliative medicine and radiation oncology
were more likely to report high confidence in palliative skills.
The main factors contributing to acquiring palliative competences were "own
experience in practice," discussions with colleagues," and "advanced training courses
and workshops." Perceived barriers to palliative care in radiation therapy included time
constraints (9%), stigmata (8%), lack of interdisciplinary collaboration (8%), and
inexperience/unawareness (6%). Of the surveyed radiation oncologists, 42% were
satisfied with training opportunities in palliative care, 39% were neutral, and 18% were
either very dissatisfied or dissatisfied. Notably, among the latter group, respondents
under the age of 50 were more frequent (20/101, 20% vs. 14/104, 13%, p=023).
The top three ranked interventions perceived as helpful in improving palliative care
were aspiring to closer collaboration with colleagues in palliative medicine (91%),
integration of a multiprofessional palliative team at a specific point in time (84%), and
integration of palliative care services with oncologic care at the time of diagnosis (65%).
Conclusions The low response rate limits generalizations, but the study highlights
Challenges and opportunities for adequate palliative care in radiation oncology. Despite
the significance of palliative care in radiation oncologists' professional lives, barriers and
limited involvement in palliative medicine persist. Further education positively impacts
satisfaction with palliative competencies, indicating the need for more supportive
programs, especially for young radiation therapists. Active lectures in radiation oncology
residencies can enhance palliative training. Overcoming barriers is essential for
successful palliative care integration in radiation oncology. Further education can
sensitize physicians to the complexity of palliative care, promoting awareness and
integration in radiation therapy
Does gender equality promote social trust? An empirical analysis
No full textFairness can be an important factor that promotes social trust among people. In this paper, I investigate empirically whether fairness between men and women increases social trust. Using the data of the World Value Survey from 91 countries, I find that gender discriminatory values negatively affect the trust level of both men and women, while actual conditions on gender equality, measured by labor and educational attainments and political participation, are not a significant determinant of social trust. Furthermore, fairness towards women is an important factor of social trust in countries where gender equality is relatively high, but the effect of the fairness is minimal in countries where there is a greater disparity in equality between the genders. Contrary to the expectation, the effect of gender equality is larger for men than women in more equal societies – a finding that calls for a closer look in a future study
Initiation of Antiresorptive Drug Treatment during Endocrine Therapy for Breast Cancer—A Retrospective Cohort Study of 161,492 Patients in Germany
No full textEndocrine therapy (ET), which significantly reduces breast cancer (BC) recurrence and mortality rates, is the primary systemic therapy for hormone receptor positive BC. However, in addition to frequently reported TAM- and AI-related side effects, such as hot flashes, arthralgias, and myalgias, treatment with AIs in particular leads to accelerated bone loss (AI-associated bone loss, AIBL) and increased bone fracture risk. To the best of our knowledge, little is known about the prescription spectrum of antiresorptive drugs in BC patients treated with ET in Germany. To explore this further, we conducted a retrospective cohort study that included 161,492 patients under ET to measure the cumulative incidence of antiresorptive drug prescription for TAM and AIs and estimate the relationship between initial drug (AIs versus TAM) and antiresorptive drug prescription. Finally, our study provides an overview of the most frequently prescribed antiresorptive drugs in Germany.Gefördert durch den Open-Access-Publikationsfonds der UB Marburg
Innovation Markets, Future Markets, or Potential Competition: How Should Competition Authorities Account for Innovation Competition in Merger Reviews?
No full textThe relevant competitors in regard to innovation might, but not necessarily do, correspond to the identified competitors on actual product markets. Hence, the conventional analysis of product markets, in order to assess the potential anticompetitive effects of mergers, is insufficient to capture innovation competition in its full extent. As a consequence, the aim of this article is to introduce and compare the existing alternative approaches which can, in principle, be used for the assessment of anticompetitive innovation effects in merger review. By focusing on the applied U.S. Antitrust, it turns out that none of the existing approaches seems to be appropriate to fully account for innovation competition. However, the ‘Innovation Market Analysis’, the first framework especially designed for the assessment of innovation aspects, might still serve as a good starting point for the development of a revised assessment framework
Neural correlates of visual and tactile path integration and their task related modulation
No full textSelf-motion induces sensory signals that allow to determine travel distance (path integration). For
veridical path integration, one must distinguish self-generated from externally induced sensory
signals. Predictive coding has been suggested to attenuate self-induced sensory responses, while
task relevance can reverse the attenuating effect of prediction. But how is self-motion processing
affected by prediction and task demands, and do effects generalize across senses? In this fMRI study,
we investigated visual and tactile self-motion processing and its modulation by task demands.
Visual stimuli simulated forward self-motion across a ground plane. Tactile self-motion stimuli were
delivered by airflow across the subjects’ forehead. In one task, subjects replicated a previously
observed distance (Reproduction/Active; high behavioral demand) of passive self-displacement
(Reproduction/Passive). In a second task, subjects travelled a self-chosen distance (Self/Active; low
behavioral demand) which was recorded and played back to them (Self/Passive). For both tasks and
sensory modalities, Active as compared to Passive trials showed enhancement in early visual areas
and suppression in higher order areas of the inferior parietal lobule (IPL). Contrasting high and low
demanding active trials yielded supramodal enhancement in the anterior insula. Suppression in the
IPL suggests this area to be a comparator of sensory self-motion signals and predictions thereof.Gefördert durch den Open-Access-Publikationsfonds der UB Marburg