German pain questionnaire and standardised documentation with the KEDOQ-Schmerz. A way for quality management in pain therapy [Deutscher schmerzfragebogen (DSF) und standardisierte dokumentation mit KEDOQ-Schmerz. Auf dem weg zur gemeinsamen qualitätsentwicklung der schmerztherapie]
Casser H.R.,Schmerztagesklinik |
Huppe M.,Universitare Schmerzambulanz |
Kohlmann T.,Institute For Community Medicine |
Korb J.,Schmerztagesklinik |
And 2 more authors.
Schmerz | Year: 2012
KEDOQ-Schmerz was developed by the German Pain Society (formerly DGSS) as a basic tool for documentation and quality management of pain therapy. It is planned to use KEDOQ-Schmerz as the data basis for nationwide, cross-sectional and independent scientific research in health services in Germany. With comparatively little effort, each participating institution (practices, pain clinics) will be able to provide quality control of their own diagnostic procedures and therapeutic effects by using benchmarking. In future KEDOQ-Schmerz will also be used as a method for external quality management in pain therapy in Germany. © Deutsche Gesellschaft zum Studium des Schmerzes. Published by Springer-Verlag - all rights reserved 2012.
Carreon D.C.,University of California at Irvine |
Baumeister S.E.,Institute For Community Medicine
Journal of Immigrant and Minority Health | Year: 2015
Few studies have examined differences in health care access across Asian American ethnicities and none have considered the effects of residential segregation. The segregation of Asians by neighborhood has been steadily increasing over the past few decades due in part to the settlement patterns of immigrants. Data from the 2009 National Longitudinal Study of Adolescent Health (n = 746) were used. We examined differences in yearly medical checkups between Asian subgroups as well as among foreign-born and US-born Asians. Results showed that immigrant Filipinos and Vietnamese were less likely to get a checkup compared with foreign-born Chinese. The effect of Asian subgroup was modified by the percentage of Asians in a census tract (p < 0.01). Koreans and other Asians had a higher probability of getting a checkup when living in a predominately Asian neighborhood. For Chinese and Vietnamese residential concentration of Asians had a stronger inverse association with having a yearly checkup. © 2015, Springer Science+Business Media New York.
Treatment satisfaction and quality-of-life between type 2 diabetes patients initiating long- vs. intermediate-acting basal insulin therapy in combination with oral hypoglycemic agents - a randomized, prospective, crossover, open clinical trial
Hermanns N.,Forschungsinstitut der Diabetes Akademie Bad Mergentheim FIDAM |
Kulzer B.,Forschungsinstitut der Diabetes Akademie Bad Mergentheim FIDAM |
Kohlmann T.,Institute For Community Medicine |
Jacob S.,Private Practice |
And 3 more authors.
Health and Quality of Life Outcomes | Year: 2015
Background: Pharmacological and clinical differences between insulin glargine and NPH insulin may translate into differences in patient reported outcomes, but existing data are equivocal. Methods: In this 48-week, open-label, randomized, multi-center, crossover phase IV trial, insulin naïve type 2 diabetes patients with blood glucose not at target on oral hypoglycemic agents had basal insulin added to their treatment regimen. A total of 343 patients were randomized to either receive insulin glargine (n = 176; sequence A) or neutral protamine Hagedorn (NPH) insulin (n = 167; sequence B) in period 1 (weeks 1-24) and vice versa in period 2 (weeks 25-48). The primary objective was to assess patient reported outcomes using a composite Diabetes Related Quality of Life (DRQoL) score based on an unweighted Insulin Treatment Experience Questionnaire (ITEQ) score, a Problem Areas in Diabetes (PAID) questionnaire score, and the mental health score in the Short Form (SF)-12® Health Survey, analyzed by analysis of covariance (ANCOVA). Results: Patients (mean age 62.3 ± 9.0; 39.5 % female) had a mean diabetes duration of 9.6 ± 5.9 years, a mean baseline HbA1c of 8.15 ± 0.72 %, and a mean fasting blood glucose (FBG) level of 9.37 ± 2.19 mmol/L. A total of 229 patients were available for primary endpoint evaluation (modified intention to treat population). Combining all data from both periods for each insulin treatment, on a 0-100 scale, the mean DRQoL score was 69.6 (±9.04) with insulin glargine and 70.0 (±9.40) with NPH insulin. Neither an effect of treatment with insulin glargine vs NPH insulin (p = 0.31) nor a period effect (p = 0.96), nor a sequence effect (p = 0.76) was observed using ANCOVA. Conclusions: The results show that in a patient population with sub-optimal glycemic control at baseline, and a low target achievement rate together with a low rate of hypoglycemia, differences in the patient reported outcomes evaluated in this study were negligible between insulin glargine and NPH insulin. © 2015 Hermanns et al.
Streit U.,Jagerbauerstrasse 12 |
Jansen F.,Dornich |
Wolf K.,Ludwig Maximilians University of Munich |
Kohlmann T.,Institute For Community Medicine
Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie | Year: 2014
Objective: This study concerns the influence of an improvement of body contact on regulatory disorders in infancy. Two interventions were examined: 1. parent counseling on the subject of body contact; 2. practical training of body contact in connection with exposure. Both methods were supplemented by a video-based parent training. Methods: 20 infants with regulatory disorder were assigned to each treatment. Body and eye contact were examined by means of video ratings before and after treatment. In addition, we measured the daily amount of crying, sleeping, feeding, being fussy, and quiet play by means of an infant behavior diary. Results: Both interventions resulted in an improvement of body contact, though only in the group with practical training was this improvement stable after 3 months. Taking all 40 participating infants together, we found significant improvements for "fussiness, " "sleep duration, " "awake, quiet or playing, " and a marginal significant intervention effect for the duration of crying. Both interventions showed that children who had markedly improved in body contact also improved with regard to the regulation problem. Finally, the practical training of body contact was superior to pure counseling respective to the fussiness of the infants and to their gaze contact. Conclusions: Body contact can be improved through specific therapeutic interventions. Video-based parent training in combination with interventions aiming at an improvement of body contact have a positive effect on the regulation problem. © 2014 Verlag Hans Huber, Hogrefe AG, Bern.
Kersten I.,Institute For Community Medicine |
Lange A.E.,University of Greifswald |
Haas J.P.,German Center for Rheumatology in Children and Adolescents |
Fusch C.,Mc Master University |
And 3 more authors.
BMC Pregnancy and Childbirth | Year: 2014
Background: The subject of " pregnancy and disease" is of particular importance for maternal well-being and neonatal outcomes. The international literature has focused on acute diseases during pregnancy; however, there are only a few studies investigating chronic diseases in pregnant women. The focus of this study is on diseases of women in childbearing age that are not related to the pregnancy. The objective of the paper is to deliver population based prevalences of chronic dieases in childbearing women and compare the two groups of chronically ill women and healthy women in detail regarding sociodemography, peri- and prenatal parameters and birth outcomes.Methods: Data of n = 5320 childbearing women were evaluated in the context of the population-based Survey of Neonates in Pomerania (SNiP). Data were obtained via face-to-face interviews, self-applied questionnaires, and abstraction from medical records at the time of giving birth. Sociodemographic and health status data were assessed, including chronic diseases that were taken out of medical records. A comprehensive set of pre- and perinatal varaiables were assessed.Results: In the SNiP, every fifth pregnant woman suffers from at least one chronic disease, and higher prevalence rates have been reported in the literature. There was a significant difference between chronically ill women and healthy women in age, education and income. Prenatal complications were more frequent in the healthy group than in the chronic disease group. Women with chronic diseases delivered by Cesarean section more frequently than women in the healthy group. Every tenth woman with at least one chronic disease gave birth to a premature infant, while only one in every 13 woman in the healthy control group gave birth to a premature infant.Conclusions: This analysis is the first population-based study in which all chronic diseases could be taken into consideration. The population-based prevalences rates in the SNiP data are consistently lower than those found in the literature. There are differences between chronically ill women and healthy women in peri- and prenatal variables as well as birth outcome on the population level. However, they are less frequent than expected and further analyses are need focusing on specific diseases. © 2014 Kersten et al.; licensee BioMed Central Ltd.