194 research outputs found
Estimations of incidences of mental disorders in statutory health insurance routine data: methodology and trends from 2006 to 2022
No full textZusammenfassung Einleitung Routinedaten der gesetzlichen Krankenversicherung (GKV) sollen zur Surveillance nichtübertragbarer Erkrankungen (NCD) am Robert Koch-Institut (RKI) auch für die Abschätzung von administrativen Inzidenzen psychischer Störungen genutzt werden. Ziel der Studie ist es, dafür eine möglichst sensitive und praktikable Methodik zu identifizieren. Methoden Mit ab 2005 verfügbaren Daten der BARMER-Krankenkasse, bei der ca. 10 % der Bevölkerung Deutschlands versichert waren, wurden kumulative Inzidenzen für die Jahre von 2006 bis 2022 nach schrittweisem Ausschluss von Personen mit vorausgehender Diagnosestellung in einem bis 17 Vorjahren zu Depressionen, Angststörungen, Schizophrenie-Spektrum-Störungen sowie psychischen Störungen mit einheitlicher bevölkerungsbezogener Standardisierung nach Geschlecht, Alter und Wohnregion ermittelt. Ergebnisse Mit Ausweitung des Vorbeobachtungszeitraums lässt sich in verschiedenen Beobachtungsjahren für alle 4 Diagnosegruppen jeweils ein gleichartiger relativer Rückgang der Inzidenzschätzer feststellen. Ab einer Vorbeobachtung von 2 Jahren unterscheiden sich bei weiterer Ausdehnung der Vorbeobachtung zwar die Werte der Inzidenzschätzer, relative Veränderungen und damit Trends werden jedoch annähernd identisch abgebildet. Ein Großteil der als inzident identifizierten Personen weist in den Vorjahren bereits Diagnosen anderer psychischer Störungen auf. Diskussion Für die Schätzung administrativer Inzidenzen erscheint der Ausschluss von Personen mit vorausgehender Diagnose in 2 Vorjahren ausreichend, um Trends abzubilden. Vergleiche und Interpretationen von Inzidenzschätzern sollten stets nur bei gleichartiger Vorbeobachtung und Methodik erfolgen. Weitere methodische Aspekte sowie Ergebnisse zu den 4 Diagnosegruppen werden diskutiert.Abstract Introduction Routine data from statutory health insurance (SHI) are to be used for the surveillance of non-communicable diseases (NCDs) at the Robert Koch Institute (RKI), including for the estimation of administrative incidences of mental disorders. The aim of the study is to identify a methodology that is as sensitive and practicable as possible. Methods Using data available from 2005 onwards from the BARMER health insurance fund, with which approximately 10% of the German population was insured, cumulative incidences were determined for the years 2006 to 2022 after gradual exclusion of persons with previous diagnoses in 1 to 17 previous years for depression, anxiety disorders, schizophrenia spectrum disorders, and mental disorders with uniform population-based standardization by gender, age, and region of residence. Results With an extension of the prior observation period, a similar relative decline in the incidence estimates can be observed for all four diagnostic groups in different observation years. From a prior observation period of two years, the values of the incidence estimators differ with further extension of the prior observation period, but relative changes and thus trends are depicted almost identically. A large proportion of the persons identified as incident already had diagnoses of other mental disorders in previous years. Discussion For the estimation of administrative incidence rates, the exclusion of persons with a previous diagnosis in two previous years appears to be sufficient to depict trends. Comparisons and interpretations of incidence estimates should only ever be made with similar prior observation and methodology. Further methodological aspects and results for the four diagnosis groups are discussed.Zusammenfassung Einleitung Routinedaten der gesetzlichen Krankenversicherung (GKV) sollen zur Surveillance nichtübertragbarer Erkrankungen (NCD) am Robert Koch-Institut (RKI) auch für die Abschätzung von administrativen Inzidenzen psychischer Störungen genutzt werden. Ziel der Studie ist es, dafür eine möglichst sensitive und praktikable Methodik zu identifizieren. Methoden Mit ab 2005 verfügbaren Daten der BARMER-Krankenkasse, bei der ca. 10 % der Bevölkerung Deutschlands versichert waren, wurden kumulative Inzidenzen für die Jahre von 2006 bis 2022 nach schrittweisem Ausschluss von Personen mit vorausgehender Diagnosestellung in einem bis 17 Vorjahren zu Depressionen, Angststörungen, Schizophrenie-Spektrum-Störungen sowie psychischen Störungen mit einheitlicher bevölkerungsbezogener Standardisierung nach Geschlecht, Alter und Wohnregion ermittelt. Ergebnisse Mit Ausweitung des Vorbeobachtungszeitraums lässt sich in verschiedenen Beobachtungsjahren für alle 4 Diagnosegruppen jeweils ein gleichartiger relativer Rückgang der Inzidenzschätzer feststellen. Ab einer Vorbeobachtung von 2 Jahren unterscheiden sich bei weiterer Ausdehnung der Vorbeobachtung zwar die Werte der Inzidenzschätzer, relative Veränderungen und damit Trends werden jedoch annähernd identisch abgebildet. Ein Großteil der als inzident identifizierten Personen weist in den Vorjahren bereits Diagnosen anderer psychischer Störungen auf. Diskussion Für die Schätzung administrativer Inzidenzen erscheint der Ausschluss von Personen mit vorausgehender Diagnose in 2 Vorjahren ausreichend, um Trends abzubilden. Vergleiche und Interpretationen von Inzidenzschätzern sollten stets nur bei gleichartiger Vorbeobachtung und Methodik erfolgen. Weitere methodische Aspekte sowie Ergebnisse zu den 4 Diagnosegruppen werden diskutiert.Abstract Introduction Routine data from statutory health insurance (SHI) are to be used for the surveillance of non-communicable diseases (NCDs) at the Robert Koch Institute (RKI), including for the estimation of administrative incidences of mental disorders. The aim of the study is to identify a methodology that is as sensitive and practicable as possible. Methods Using data available from 2005 onwards from the BARMER health insurance fund, with which approximately 10% of the German population was insured, cumulative incidences were determined for the years 2006 to 2022 after gradual exclusion of persons with previous diagnoses in 1 to 17 previous years for depression, anxiety disorders, schizophrenia spectrum disorders, and mental disorders with uniform population-based standardization by gender, age, and region of residence. Results With an extension of the prior observation period, a similar relative decline in the incidence estimates can be observed for all four diagnostic groups in different observation years. From a prior observation period of two years, the values of the incidence estimators differ with further extension of the prior observation period, but relative changes and thus trends are depicted almost identically. A large proportion of the persons identified as incident already had diagnoses of other mental disorders in previous years. Discussion For the estimation of administrative incidence rates, the exclusion of persons with a previous diagnosis in two previous years appears to be sufficient to depict trends. Comparisons and interpretations of incidence estimates should only ever be made with similar prior observation and methodology. Further methodological aspects and results for the four diagnosis groups are discussed
Assessing Perceived Need for Mental Healthcare Among Adults in Germany
No full textObjectives To describe the prevalence and distribution of perceived need for mental healthcare among adults in Germany and examine its association with more objective indicators of need as well as mental health literacy. Methods We used data from 6,558 adults randomly sampled from a health insurance company as well as nationally representative survey data from 10,676 adults. Prevalence estimates were calculated, also by sex, age and education. Bivariate and multivariate associations between perceived need and sociodemographic characteristics, psychopathological symptoms, functional impairment and F-diagnoses as well as mental health literacy were examined. Results Approximately one-sixth of adults perceived a need for mental healthcare in the previous 12 months. Perceived need was associated with female sex (bivariate association only), younger age, high educational attainment, psychopathological symptoms, mental health-related functional impairment and mental health literacy. Those with perceived need were also twice as likely to have a documented F-diagnosis than those without. Conclusion Perceived need should be monitored within mental health surveillance to inform healthcare planning from a patient perspective and address the mental health treatment gap
The presentation of authorship in the works of Uwe Timm
No full textDie vorliegende Dissertation befasst sich mit der Frage der Inszenierung der Autorschaft am Beispiel von Uwe Timm. Dieser Problematik geht sie nach, indem sie vier unterschiedliche „begleitende“ Genres untersucht: Zeitschriften und Zeitungen, Reiseberichte, Autobiographien und Poetikvorlesungen, welche unter dem Begriff „Medien der Autorschaft“ nach Urs Meyer zu verstehen sind. Das Erkenntnisinteresse dieser Arbeit richtet sich auf die medialen Erscheinungsformen einerseits und auf die Darstellungsweise der Autorschaft andererseits. Auf dieser Grundlage werden multiple Autorbilder von Uwe Timm vor dem Hintergrund des Konzepts des literarischen Felds und des Habitus von Pierre Bourdieu herausgearbeitet: der politisch engagierte Autor, der Autor als Ethnologe, der Autor als Erinnerungsarbeiter des kollektiven Gedächtnisses sowie der Autor als Geschichtenerzähler.This dissertation addresses the question of how authorship is presented in the works of Uwe Timm. To explore this issue, four different “accompanying” genres have been considered: journals and newspapers, travel writings, autobiographies and poetic lectures, all of which are to be understood as “Media of Authorship” according to Urs Meyer. The discussion revolves around two aspects, the forms of media on the one hand, and the representational techniques on the other. Through Pierre Bourdieu’s concept of literary field and habitus, Uwe Timm’s multiple author images have been highlighted: the politically engaged author, the author as an ethnologist, the author as a memory worker of the collective memory and the author as a storyteller
Entrevista com André Timm: corpos, migração e linguagem em seu romance Morte Sul Peste Oeste
No full textInterview with André Timm, a Brazilian author from Porto Alegre and based in Santa Catarina. In this interview, interesting aspects present in his latest novel, Morte Sul Peste Oeste (2020), are revealed.Entrevista a André Timm, autor brasileño natural de Porto Alegre y radicado em Santa Catarina. En esta entrevista se revelan aspectos interesantes presentes en su última novela, Morte Sul Peste Oeste (2020). Entrevista a André Timm, autor brasileiro natural de Porto Alegre e radicado em Santa Catarina. Nesta entrevista revelam-se aspectos interessantes desenvolvidos no seu último romance, Morte Sul Peste Oeste (2020).
Motive of food and its significance for the work of Uwe Timm
No full textThis thesis deals with the subject of food and its aspects in the work of Uwe Timm. The first part depicts different areas from everyday life which are in some way linked to food. German-speaking writers are mentioned for comparison since they address the subject of food in their literary works in some way as well. In the next section the biography of the author is presented, since he incorporates his autobiographical features and experiences in his work. Based on motive research, selected literary works by Uwe Timm are examined and different nuances of the aspect of food are presented. KEY WORDS food, motive of food, motive research, Uwe Timm, literatur
Risk Factors for Prolonged Mechanical Ventilation and Weaning Failure: A Systematic Review
No full text<b><i>Introduction:</i></b> Prolonged mechanical ventilation (PMV) and weaning failure are factors associated with prolonged hospital length of stay and increased morbidity and mortality. In addition to the burden these places on patients and their families, it also imposes high costs on the public health system. The aim of this systematic review was to identify risk factors for PMV and weaning failure. <b><i>Methods:</i></b> The study was conducted according to PRISMA guidelines. After a comprehensive search of the COCHRANE Library, CINHAL, Web of Science, MEDLINE, and the LILACS Database a PubMed request was made on June 8, 2020. Studies that examined risk factors for PMV, defined as mechanical ventilation ≥96 h, weaning failure, and prolonged weaning in German and English were considered eligible; reviews, meta-analyses, and studies in very specific patient populations whose results are not necessarily applicable to the majority of ICU patients as well as pediatric studies were excluded from the analysis. This systematic review was registered in the PROSPERO register under the number CRD42021271038. <b><i>Results:</i></b> Of 532 articles identified, 23 studies with a total of 23,418 patients met the inclusion criteria. Fourteen studies investigated risk factors of PMV including prolonged weaning, 9 studies analyzed risk factors of weaning failure. The concrete definitions of these outcomes varied considerably between studies. For PMV, a variety of risk factors were identified, including comorbidities, site of intubation, various laboratory or blood gas parameters, ventilator settings, functional parameters, and critical care scoring systems. The risk of weaning failure was mainly related to age, previous home mechanical ventilation (HMV), cause of ventilation, and preexisting underlying diseases. Elevated PaCO<sub>2</sub> values during spontaneous breathing trials were indicative of prolonged weaning and weaning failure. <b><i>Conclusion:</i></b> A direct comparison of risk factors was not possible because of the heterogeneity of the studies. The large number of different definitions and relevant parameters reflects the heterogeneity of patients undergoing PMV and those discharged to HMV after unsuccessful weaning. Multidimensional scores are more likely to reflect the full spectrum of patients ventilated in different ICUs than single risk factors
Nachgetragene Erinnerung: Uwe Timm, „Am Beispiel meines Bruders“ (2003) und Robert Schiff, „Feldpostbriefe. Chronik eines ungebauten Hauses“ (1994)
No full textUwe Timm and Robert Schiff have both written an autobiographical text dealing with the premature death of an elder brother who was a combattant in the Waffen-SS in their childhood. Despite the frappantly similar biographical constellation, there are differences in narrative technique and thematical focus that stem from their respective sociocultural context. The analysis shows that Timm is in many ways a representative author of the German ‘68 generation that critically reevaluates the attitude of their parents during the national socialist period and points to omissions and falsifications in the oral family history, while the narration of Schiff, an emigrated author born in the pre-war milieu of the German minority of Southwest Romania, is mainly a reconstruction of the impact of big history on his childhood and thus also the effort to conserve the memory of a world that has passed away and to reconcile himself with the experience of loss
Von Andreas Gryphius zu Uwe Timm: deutsche Parallelwege in der Aufnahme von Italiens Kunst, Poesie und Politik
No full textDeutsche Parallelwege in der Aufnahme von italiens Kunst, Poesie und Politik beabsichtigen das Italien-Bild aufgrund von jeweils zwei Texten deutscher Autoren, vornehmlich des späten 18. und des 19. Jahrhunderts zu untersuchen. Es wird z. B. die Bewertung der kunst der italienischen Renaissance bei Goethe und Wackenroeder thematisiert oder der deutsche Blick auf italienische Politik von zwei grundverschiedenen Autoren wie Karl Grün und Heinrich Hansjakob sowie als Nachklang bei Uwe Timm im späten 20. Jahrhundert behandelt. Ziel der Textanalyse ist weniger ein wertender Vergleich der beiden ausgewählten Autoren als vielmehr die Differenzen und Ahnlichkeiten sowohl in der literarischen Darbietung als auch im Blick auf Italien bei einem gleichen Thema klarer zum Vorschein kommen zu lassen. L’autore descrive l’immagine dell’Italia (arte, poesia, antropologia e politica) così come essa è rappresentata nella letteratura tedesca da Andreas Gryphius (1644) fino a Uwe Timm (1989). Attraverso l’analisi di testi di Andreas Gryphius, Johann Caspar, Johann Wolfgang Goethe, Wilhelm Heinrich Wackenroder, Joseph von Eichendorff, Johann Wilhelm von Archenholtz, Gustav Nicolai, Viktor Hehn, Paul Heyse, Ludwig Tiek, August Wilhelm Schlegel, Friedrich Schiller, Karl Grün, Heinrich Hansjakob, Theodor Fontane, Norbert C. Kaser e Uwe Timm vengono affrontate di riflesso le opere di Andrea Palladio, Carlo Cattaneo, Giuseppe Mazzini e Francesco De Sanctis in relazione sia al mito romantico del Rinascimento italiano sia a quello del Romanticismo tedesco nel Risorgimento italiano. Tematizzato viene poi il mito di Garibaldi versus Pio IX, e quello del comunismo nell’Italia meridionale del secondo Ottocento in relazione alla figura Antonio Gramsci nel 1933; quindi l’Italia come utopia romantica nel primo Ottocento e il paesaggio italiano come paradiso terrestre alla metà dello stesso secolo; infine, l’immagine di Roma moderna come città eterna
Zur Vereinbarkeit von Pflege und Beruf: Quantitative und qualitative Perspektiven
No full textReconciling Informal Care and Work: Quantitative and Qualitative PerspectivesThis article discusses the issue of reconciliation of care and employment from two different angles: In the first part, effects of care policies on the employment status of previous full-time employed caregivers in 34 European regions are analyzed. Based on quantitative multilevel models, it is shown that rising state transfer payments make it more likely that caregivers leave their job. The second part, which is based on qualitative interviews, focuses employed care giving sons in Germany and reveals the maintenance of work despite care responsibilities. Furthermore, the importance of informal support and defamilising measures for combining care and work are presented. Finally, the value of both perspectives is elaborated
A liberal developmental state in Georgia?
No full textStandard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may The Author Christian Timm Christian Timm is a researcher at PFH Goettingen and works within the framework of the research network "Institutions and Institutional Change in Postsocialism" funded by the Federal Ministry of Education and Research (BMBF). His research focuses on stateeconomy relations and economic policy in Central Asia and the Southern Caucasus. He holds a degree from European-University Viadrina and is a PhD candidate at Humboldt-University Berlin. 1 A liberal developmental state in Georgia? State dominance and Washington Consensus in the post--communist region. Christian Timm * Abstract The article analyzes state dominance in Georgia's economy between 2003 and 2010 from the perspective of the (new) developmental state. The specific interlinkage of economic model, law and administration through which state interventions may generate market-enhancing effects provides the analytical framework for the examination of Georgia's institutional setting
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