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Steinau an der Strasse, Germany

Muhlbacher A.C.,University of Applied Sciences Neubrandenburg | Nubling M.,GEB MbH
European Journal of Health Economics

Background: Against the background of patient involvement, understanding patients' preferences for treatments is crucial: Do physicians have the same or a different perception of the patients' preferences? As there is currently no cure for patients with multiple myeloma, primary objectives of treatment are to extend survival at the best possible quality of life. In this study, physicians' beliefs about patients' preferences regarding the treatment of multiple myeloma (MM) were explored in a direct assessment and a discrete choice experiment (DCE), and were compared to the previously explored patients' views. How much do physicians know about their patients' preferences? Methods: In a preceding study with German multiple myeloma patients, relevant attributes of an ideal multiple myeloma treatment were collected by reviewing the literature and by conducting a qualitative study with focus groups. The attributes were analyzed using both a direct measurement (16 items on a five-point Likert scale) and a DCE (eight pairs with eight characteristics). For the present study, 30 German physicians reviewed the treatment attributes from the previous study for completeness. A total of 243 physicians participated in the study (including the 30 participants in the pre-test). The direct assessment and the DCE covered four major preference dimensions that both the literature review and the focus groups revealed: Aspects of medical effectiveness (including prolonged life expectancy, effectiveness and long duration of effect), side effects, quality of life (including social, physical and emotional quality of life) and flexibility (breaks in therapy and further treatment options). Results: In the direct measurement of patients' preferences, physicians rated physical quality of life (specified as "reduced mobility or good mobility"), rare side effects and effectiveness aspects (duration of effect, maximal prolonged life expectancy and effectiveness) as the most important attributes from the patients' perspective, followed by emotional quality of life (specified as "Not always think of the disease") and therapy-free intervals. Especially further treatment options and dosage were more important to patients than physicians believed. In this case, the physicians had quite obviously underestimated the importance of these attributes from the perspective of those affected. Physicians ranked prolonged life expectancy as relatively the most important and significantly more important than all other treatment attributes. Further treatment options were the second most important attribute and significant compared to the attributes breaks in therapy and physical quality of life, whereas the patients ordered these two attributes in reverse order. Similarly, the patients gave the opposite relative importance to the next two priorities: self-application of treatment and emotional quality of life. Conclusions: Asking patients or physicians about the multiple myeloma patients' treatment preferences, the combination of direct assessment and DCE proves to be a valid survey technique. Over a broad range of treatment attributes, the physicians' perceptions of preferences were very close to those of multiple myeloma patients. Both the direct assessment of importance in order to rank the patient perceptions and the DCE provide important insights into the preference structure of patients with multiple myeloma. The findings can subsequently be used as a basis for tailoring health care services for multiple myeloma patients in reference to their preferences. © 2010 Springer-Verlag. Source

Kraft V.,University of Applied Sciences Neubrandenburg
Zeitschrift fur Padagogik

On the basis of recent empirical findings, the theory-related problems of general pedagogy are examined from a disciplinary perspective. In this, the common distinction between profession and discipline is differentiated in more detail by showing that modern educational science - in contrast to theology, law, or medicine - is to be considered a secondary discipline the development of which is directly related to processes of secondary professionalization. Against this background, the author substantiates his proposal to determine a dual function of general pedagogy: on the one hand, it serves as delimitation against other disciplines (interdisciplinary aspect), and on the other hand, it serves the intra-disciplinary integration with regard to differential pedagogies. Both functions converge in an operative understanding of education in which the identity of educational science is reflected. Source

Kohler M.,University of Applied Sciences Neubrandenburg | Poll P.H.,Atmosfair gGmbH
Ecological Engineering

In Germany, the construction of extensive greenroofs has been a tradition for over 100 years. This study picked up older Berlin research conducted in 1960, 1982, 1986, 1987, 1990, 1995 and compared it with current findings (Poll, 2008). The older research was made either on the old "Tar-Paper-Greenroofs" (TPG-roofs), established between 1880 and 1930, or on the first systematically vegetated Modern Extensive Greenroofs (MEG-roofs), established in the 1980s. This survey compares both roof types and supplements the chronology of analysis. The research showed that MEG and especially TPG are resilient roof types and can last up to 100 years. About 70 vascular plant species were found on the surveyed roofs (> 10 % resp. consistency). Regarding the growing media, we could show that total porosity rises over a period of 10 years from 50 to 60%. In the meantime C/N-ratio falls from initially 25 down to 13. While the pH of the slightly acidic TPG-media rose to neutral, the slightly alkaline MEG-media sank down to neutral. With the help of a specially developed vegetation quality index, which incorporates both relative plant coverage and species quantity, we could show that media depth and the grade of sunlight exposition influence floral quality of greenroofs as well as how. According to the specified criteria, the quality of the modern extensive greenroofs is significantly higher than the quality of the 100-year-old ones. Nevertheless, a significant correlation between water holding capacity and vegetation coverage was shown for both roof types. © 2010 Elsevier B.V. All rights reserved. Source

Muhlbacher A.C.,University of Applied Sciences Neubrandenburg | Muhlbacher A.C.,Gesellschaft fur empirische Beratung GmbH GEB | Bethge S.,University of Applied Sciences Neubrandenburg
European Journal of Health Economics

Objective: Lung cancer is a major cause of cancer-related deaths and thus represents a global health problem. According to World Health Organization (WHO) estimates, approximately 1.37 million people die each year from lung cancer. Different therapeutic approaches as well as several treatment options exist. To date decisions on which therapies to use have largely been made by clinical experts. Comparative preference studies show that underlying weighting of treatment goals by experts is not necessarily congruent with the preferences of affected patients. Aim and methods: The aim of this empirical study was to ascertain patient preferences in relation to treatment of non-small-cell lung cancer (NSCLC). After identification of patient-relevant treatment attributes via literature review and qualitative interviews(ten) a discrete-choice experiment including seven patient-relevant attributes was conducted using a fractional factorial NGene-design. Statistical data analysis was performed using latent class models. Results: The qualitative part of this study identified outcome measures related to efficacy, side effects and mode of administration. A total of 211 NSCLC patients (N = 211) participated in the computer-assisted personal interview. A clear preference for an increase in “progression-free survival” (coef.: 1.087) and a reduction of “tumor-associated symptoms”(cough, shortness of breath and pain); coef.: 1.090) was demonstrated, followed by the reduction of side effects: “nausea and vomiting” (coef.: 0.605); “rash” (coef.: 0.432); “diarrhea” (coef.: 0.427); and, “tiredness and fatigue” (coef.: 0.423). The “mode of administration” was less important for participants (coef.: 0.141). Conclusion: Preference measurement showed “progression-free survival” and “tumor-associated symptoms” had a significant influence on the treatment decision. Subgroup analysis revealed that the importance of “progression-free survival” increases with increased therapy experience. Based on the presented results therapies can be designed, assessed and chosen on the basis of patient-oriented findings. As such, more effective and efficient care of patients can be achieved and benefits increased. © 2014, The Author(s). Source

Engel P.,University of Applied Sciences Neubrandenburg | Schweimler B.,University of Applied Sciences Neubrandenburg
Journal of Applied Geodesy

The deformation monitoring of structures and buildings is an important task field of modern engineering surveying, ensuring the standing and reliability of supervised objects over a long period. Several commercial hardware and software solutions for the realization of such monitoring measurements are available on the market. In addition to them, a research team at the University of Applied Sciences in Neubrandenburg (NUAS) is actively developing a software package for monitoring purposes in geodesy and geotechnics, which is distributed under an open source licence and free of charge. The task of managing an open source project is well-known in computer science, but it is fairly new in a geodetic context. This paper contributes to that issue by detailing applications, frameworks, and interfaces for the design and implementation of open hardware and software solutions for sensor control, sensor networks, and data management in automatic deformation monitoring. It will be discussed how the development effort of networked applications can be reduced by using free programming tools, cloud computing technologies, and rapid prototyping methods. © 2016 Walter de Gruyter GmbH, Berlin/Munich/Boston. Source

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