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Müller A, Hebben F, Dillen K, Dunkl V, Goereci Y, Voltz R, Löcherbach P, Warnke C, Golla H. "So at least now I know how to deal with things myself, what I can do if it gets really bad again"-experiences with a long-term cross-sectoral advocacy care and case management for severe multiple sclerosis: a qualitative study. BMC Health Serv Res 2024; 24:453. [PMID: 38600493 PMCID: PMC11007872 DOI: 10.1186/s12913-024-10851-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Persons with severe Multiple Sclerosis (PwsMS) face complex needs and daily limitations that make it challenging to receive optimal care. The implementation and coordination of health care, social services, and support in financial affairs can be particularly time consuming and burdensome for both PwsMS and caregivers. Care and case management (CCM) helps ensure optimal individual care as well as care at a higher-level. The goal of the current qualitative study was to determine the experiences of PwsMS, caregivers and health care specialists (HCSs) with the CCM. METHODS In the current qualitative sub study, as part of a larger trial, in-depth semi-structured interviews with PwsMS, caregivers and HCSs who had been in contact with the CCM were conducted between 02/2022 and 01/2023. Data was transcribed, pseudonymized, tested for saturation and analyzed using structuring content analysis according to Kuckartz. Sociodemographic and interview characteristics were analyzed descriptively. RESULTS Thirteen PwsMS, 12 caregivers and 10 HCSs completed interviews. Main categories of CCM functions were derived deductively: (1) gatekeeper function, (2) broker function, (3) advocacy function, (4) outlook on CCM in standard care. Subcategories were then derived inductively from the interview material. 852 segments were coded. Participants appreciated the CCM as a continuous and objective contact person, a person of trust (92 codes), a competent source of information and advice (on MS) (68 codes) and comprehensive cross-insurance support (128 codes), relieving and supporting PwsMS, their caregivers and HCSs (67 codes). CONCLUSIONS Through the cross-sectoral continuous support in health-related, social, financial and everyday bureaucratic matters, the CCM provides comprehensive and overriding support and relief for PwsMS, caregivers and HCSs. This intervention bears the potential to be fine-tuned and applied to similar complex patient groups. TRIAL REGISTRATION The study was approved by the Ethics Committee of the University of Cologne (#20-1436), registered at the German Register for Clinical Studies (DRKS00022771) and in accordance with the Declaration of Helsinki.
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Affiliation(s)
- Anne Müller
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
| | - Fabian Hebben
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Kim Dillen
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Veronika Dunkl
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Yasemin Goereci
- Department of Neurology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), University of Cologne, Cologne, Germany
- Center for Health Services Research, University of Cologne, Cologne, Germany
| | - Peter Löcherbach
- German Society of Care and Case Management E.V. (DGCC), Münster, Germany
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Heidrun Golla
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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2
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Senathirajah K, Bonner M, Schuyler Q, Palanisami T. A disaster risk reduction framework for the new global instrument to end plastic pollution. J Hazard Mater 2023; 449:131020. [PMID: 36805444 DOI: 10.1016/j.jhazmat.2023.131020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
There are many benefits to be realized by applying a disaster risk reduction framework to the context of plastic pollution, especially in regards to operationalizing the precautionary principle that is inherent in many international treaties and conventions. We explore the implications of framing plastic pollution as a 'disaster' in light of the development of the new global instrument to end plastic pollution by aligning the objectives of the United Nations (UN) Sendai Framework for Disaster Risk Reduction 2015-2030 (SF) and the UN Sustainable Development Goals (SDGs); and thereby also complementing the many climate and non-climate mandates embedded within the UN Framework Convention on Climate Change (UNFCCC). It has been proposed that the UN global instrument to end plastic pollution could be based on the guidelines of the Paris Agreement (PA), driven by national action plans, potential to offset and mandatory reporting requirements. Adding a disaster risk reduction lens to this approach will strongly complement and enhance the environmental and human health outcomes aspired for the global and legally binding treaty to end plastic pollution. We provide an overview to reinforce the mutual benefits of cooperation and coordination, linking the SF, UNFCCC and SDGs to the future international instrument.
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Affiliation(s)
- Kala Senathirajah
- Environmental and Plastic Innovation Cluster (EPIC), Global Innovative Centre for Advanced Nanomaterials (GICAN), School of Engineering, University of Newcastle, Callaghan, NSW 2308, Australia; Engineers Australia, 11 National Circuit, Barton, ACT 2600, Australia.
| | - Mark Bonner
- Engineers Australia, 11 National Circuit, Barton, ACT 2600, Australia
| | - Qamar Schuyler
- Commonwealth Scientific and Industrial Research Organization (CSIRO) Oceans and Atmosphere, Hobart, TAS 7001, Australia
| | - Thava Palanisami
- Environmental and Plastic Innovation Cluster (EPIC), Global Innovative Centre for Advanced Nanomaterials (GICAN), School of Engineering, University of Newcastle, Callaghan, NSW 2308, Australia
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3
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Conradt T, Engelhardt H, Menz C, Vicente-Serrano SM, Farizo BA, Peña-Angulo D, Domínguez-Castro F, Eklundh L, Jin H, Boincean B, Murphy C, López-Moreno JI. Cross-sectoral impacts of the 2018-2019 Central European drought and climate resilience in the German part of the Elbe River basin. Reg Environ Change 2023; 23:32. [PMID: 36741241 PMCID: PMC9890441 DOI: 10.1007/s10113-023-02032-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The 2018-2019 Central European drought was probably the most extreme in Germany since the early sixteenth century. We assess the multiple consequences of the drought for natural systems, the economy and human health in the German part of the Elbe River basin, an area of 97,175 km2 including the cities of Berlin and Hamburg and contributing about 18% to the German GDP. We employ meteorological, hydrological and socio-economic data to build a comprehensive picture of the drought severity, its multiple effects and cross-sectoral consequences in the basin. Time series of different drought indices illustrate the severity of the 2018-2019 drought and how it progressed from meteorological water deficits via soil water depletion towards low groundwater levels and river runoff, and losses in vegetation productivity. The event resulted in severe production losses in agriculture (minus 20-40% for staple crops) and forestry (especially through forced logging of damaged wood: 25.1 million tons in 2018-2020 compared to only 3.4 million tons in 2015-2017), while other economic sectors remained largely unaffected. However, there is no guarantee that this socio-economic stability will be sustained in future drought events; this is discussed in the light of 2022, another dry year holding the potential for a compound crisis. Given the increased probability for more intense and long-lasting droughts in most parts of Europe, this example of actual cross-sectoral drought impacts will be relevant for drought awareness and preparation planning in other regions. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10113-023-02032-3.
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Affiliation(s)
- Tobias Conradt
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
| | - Henry Engelhardt
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
| | - Christoph Menz
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
| | - Sergio M. Vicente-Serrano
- Instituto Pirenaico de Ecología Consejo Superior de Investigaciones Científicas (IPE–CSIC), Zaragoza, Spain
| | - Begoña Alvarez Farizo
- Instituto Pirenaico de Ecología Consejo Superior de Investigaciones Científicas (IPE–CSIC), Zaragoza, Spain
| | - Dhais Peña-Angulo
- Instituto Pirenaico de Ecología Consejo Superior de Investigaciones Científicas (IPE–CSIC), Zaragoza, Spain
| | - Fernando Domínguez-Castro
- Aragonese Agency for Research and Development Researcher (ARAID), Zaragoza, Spain
- Department of Geography, University of Zaragoza, Zaragoza, Spain
| | - Lars Eklundh
- Department of Physical Geography and Ecosystem Science, Lund University, Lund, Sweden
| | - Hongxiao Jin
- Department of Physical Geography and Ecosystem Science, Lund University, Lund, Sweden
| | - Boris Boincean
- Selectia Research Institute of Field Crops, Bălți, Moldova
| | - Conor Murphy
- Irish Climate Analysis and Research UnitS (ICARUS), Department of Geography, Maynooth University, Maynooth, Ireland
| | - J. Ignacio López-Moreno
- Instituto Pirenaico de Ecología Consejo Superior de Investigaciones Científicas (IPE–CSIC), Zaragoza, Spain
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Harpham T, Tetui M, Smith R, Okwaro F, Biney A, Helzner J, Duminy J, Parnell S, Ganle J. Urban Family Planning in Sub-Saharan Africa: an Illustration of the Cross-sectoral Challenges of Urban Health. J Urban Health 2022; 99:1044-1053. [PMID: 35699888 PMCID: PMC9195389 DOI: 10.1007/s11524-022-00649-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 12/31/2022]
Abstract
The multi-sectoral nature of urban health is a particular challenge, which urban family planning in sub-Saharan Africa illustrates well. Rapid urbanisation, mainly due to natural population increase in cities rather than rural-urban migration, coincides with a large unmet urban need for contraception, especially in informal settlements. These two phenomena mean urban family planning merits more attention. To what extent are the family planning and urban development sectors working together on this? Policy document analysis and stakeholder interviews from both the family planning and urban development sectors, across eight sub-Saharan African countries, show how cross-sectoral barriers can stymie efforts but also identify some points of connection which can be built upon. Differing historical, political, and policy landscapes means that entry points to promote urban family planning have to be tailored to the context. Such entry points can include infant and child health, female education and employment, and urban poverty reduction. Successful cross-sectoral advocacy for urban family planning requires not just solid evidence, but also internal consensus and external advocacy: FP actors must consensually frame the issue per local preoccupations, and then communicate the resulting key messages in concerted and targeted fashion. More broadly, success also requires that the environment be made conducive to cross-sectoral action, for example through clear requirements in the planning processes' guidelines, structures with focal persons across sectors, and accountability for stakeholders who must make cross-sectoral action a reality.
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Affiliation(s)
| | - Moses Tetui
- University of Waterloo, Waterloo, Canada.,Makerere University, Kampala, Uganda
| | | | | | | | - Judith Helzner
- International Union for the Scientific Study of Population, Paris, France. .,J. F. Helzner Consulting, Stamford, CT, USA.
| | - James Duminy
- University of Bristol, Bristol, UK.,University of Cape Town, Cape Town, South Africa
| | - Susan Parnell
- University of Bristol, Bristol, UK.,University of Cape Town, Cape Town, South Africa
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5
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Bruhn M, Laugesen H, Kromann-Larsen M, Trevino CS, Eplov L, Hjorthøj C, Carlsson J. The effect of an integrated care intervention of multidisciplinary mental health treatment and employment services for trauma-affected refugees: study protocol for a randomised controlled trial. Trials 2022; 23:859. [PMID: 36209104 PMCID: PMC9547630 DOI: 10.1186/s13063-022-06774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background The complexity of past trauma and ongoing post-migration stressors challenges the existing mental health treatment for trauma-affected refugees. Therefore, interventions are needed to accommodate these complex challenges in mental health treatment. This study examines the effect of an add-on integrated care intervention compared to treatment as usual (TAU) for trauma-affected refugees in a randomised controlled trial (RCT). Methods The study is carried out at a Danish outpatient clinic and will include 197 treatment-seeking refugees with post-traumatic stress disorder (PTSD) who are unemployed and affiliated with municipal employment services. Mental health TAU comprises 10 sessions with a medical doctor (pharmacological treatment and psychoeducation) and 16–20 sessions with a psychologist (manual-based cognitive behavioural therapy) for a period of 8 to 12 months. The add-on intervention strengthens coordination between mental health treatment and employment interventions with three cross-sectoral collaborative meetings during the mental health treatment. The integrated care intervention draws attention to the bidirectional impact of mental health problems and post-migration stressors and focuses on cross-sectoral shared plans. The primary outcome is functioning, measured by WHODAS 2.0, the interviewer-administered 12-item version, with secondary outcomes measuring quality of life, mental health symptoms, and post-migration stressors. Discussion The RCT is novel in intervention design for trauma-affected refugees and will bring forward new perspectives and knowledge of integrated care interventions for trauma-affected refugees. The integrated care intervention is expected to reduce post-migration stressors that negatively affect the treatment of trauma-related mental health problems, thereby improving preconditions for enhanced treatment outcomes. The intervention builds on existing practices in the Danish healthcare and employment sectors, which ensures high scalability and sustainability for future practices. Trial registration ClinicalTrials.gov Identifier: NCT04244864, registered 28 January 2020. Protocol version: 17 September 2022, version 2. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06774-z.
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Affiliation(s)
- Maja Bruhn
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark.
| | - Henriette Laugesen
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark
| | - Matilde Kromann-Larsen
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark
| | - Cathrine Selnes Trevino
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Lene Eplov
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Gentofte, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Gentofte, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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6
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Schons M, Pilgram L, Reese JP, Stecher M, Anton G, Appel KS, Bahmer T, Bartschke A, Bellinghausen C, Bernemann I, Brechtel M, Brinkmann F, Brünn C, Dhillon C, Fiessler C, Geisler R, Hamelmann E, Hansch S, Hanses F, Hanß S, Herold S, Heyder R, Hofmann AL, Hopff SM, Horn A, Jakob C, Jiru-Hillmann S, Keil T, Khodamoradi Y, Kohls M, Kraus M, Krefting D, Kunze S, Kurth F, Lieb W, Lippert LJ, Lorbeer R, Lorenz-Depiereux B, Maetzler C, Miljukov O, Nauck M, Pape D, Püntmann V, Reinke L, Römmele C, Rudolph S, Sass J, Schäfer C, Schaller J, Schattschneider M, Scheer C, Scherer M, Schmidt S, Schmidt J, Seibel K, Stahl D, Steinbeis F, Störk S, Tauchert M, Tebbe JJ, Thibeault C, Toepfner N, Ungethüm K, Vadasz I, Valentin H, Wiedmann S, Zoller T, Nagel E, Krawczak M, von Kalle C, Illig T, Schreiber S, Witzenrath M, Heuschmann P, Vehreschild JJ. The German National Pandemic Cohort Network (NAPKON): rationale, study design and baseline characteristics. Eur J Epidemiol 2022; 37:849-870. [PMID: 35904671 PMCID: PMC9336157 DOI: 10.1007/s10654-022-00896-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
Abstract
The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON’s goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36–62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON’s design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities. Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04768998.https://clinicaltrials.gov/ct2/show/NCT04747366.https://clinicaltrials.gov/ct2/show/NCT04679584
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Affiliation(s)
- Maximilian Schons
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pilgram
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Jens-Peter Reese
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany
| | - Gabriele Anton
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Katharina S. Appel
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Thomas Bahmer
- Internal Medicine Department I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Alexander Bartschke
- Core Facility Digital Medicine and Interoperability, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Carla Bellinghausen
- Department of Respiratory Medicine and Allergology, Medical Clinic 1, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Inga Bernemann
- Hannover Medical School, Hannover Unified Biobank, Hannover, Germany
| | - Markus Brechtel
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Folke Brinkmann
- Department of Paediatric Pneumology, Allergy and CF- Centre, University Children’s Hospital, Ruhr- University Bochum, Bochum, Germany
| | - Clara Brünn
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christine Dhillon
- COVID-19 Task Force, University Hospital Augsburg, Augsburg, Germany
| | - Cornelia Fiessler
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Ramsia Geisler
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Eckard Hamelmann
- Department of Pediatrics, Children’s Center Bethel, University Hospital East Westphalia, University Bielefeld, Bielefeld, Germany
| | - Stefan Hansch
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
| | - Frank Hanses
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
| | - Sabine Hanß
- University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
| | - Susanne Herold
- Department of Internal Medicine V, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany
- Department of Internal Medicine, German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Justus Liebig University Giessen, Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
| | - Ralf Heyder
- NUM Coordination Office, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Anna-Lena Hofmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Sina Marie Hopff
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anna Horn
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Carolin Jakob
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Steffi Jiru-Hillmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Keil
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Yascha Khodamoradi
- Department of Infectious Diseases, Medical Clinic 2, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Mirjam Kohls
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Monika Kraus
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
| | - Dagmar Krefting
- University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
| | - Sonja Kunze
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, and Department of Medicine I, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Lena Johanna Lippert
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU, Munich, Germany
- Medical Heart Center of Charité and German Heart Institute Berlin, Institute of Computer-Assisted Cardiovascular Medicine, Berlin, Germany
| | - Bettina Lorenz-Depiereux
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
| | - Corina Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Olga Miljukov
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Daniel Pape
- Department I of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Valentina Püntmann
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt am Main, Frankfurt, Germany
| | - Lennart Reinke
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christoph Römmele
- COVID-19 Task Force, University Hospital Augsburg, Augsburg, Germany
| | - Stefanie Rudolph
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin, Joint Charité and BIH Clinical Study Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Julian Sass
- Core Facility Digital Medicine and Interoperability, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Schäfer
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK e.V. (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Jens Schaller
- Medical Heart Center of Charité and German Heart Institute Berlin, Institute of Computer-Assisted Cardiovascular Medicine, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt – Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Mario Schattschneider
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christian Scheer
- Department of Anesthesiology and Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Margarete Scherer
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Sein Schmidt
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Clinical Study Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Julia Schmidt
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Kristina Seibel
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dana Stahl
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- University Medicine Greifswald, Greifswald, Germany
| | - Fridolin Steinbeis
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Maike Tauchert
- Institute of Epidemiology, Helmholtz Center Munich, Munich, Germany
| | - Johannes Josef Tebbe
- Department of Gastroenterology and Infectious Disease, University Medical Center East Westphalia-Lippe, Klinikum Lippe, Detmold, Germany
| | - Charlotte Thibeault
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Carl Gustav Carus University Hospital, TU Dresden, Dresden, Germany
| | - Kathrin Ungethüm
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Istvan Vadasz
- Institute for Lung Health (ILH), Giessen, Germany
- Department of Internal Medicine, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Frankfurt, Germany
| | - Heike Valentin
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- University Medicine Greifswald, Greifswald, Germany
| | - Silke Wiedmann
- NUM Coordination Office, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Zoller
- Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Eike Nagel
- German Center for Cardiovascular Diseases (DZHK), Berlin, Germany
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt am Main, Frankfurt, Germany
| | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christof von Kalle
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin, Joint Charité and BIH Clinical Study Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Illig
- Hannover Medical School, Hannover Unified Biobank, Hannover, Germany
| | - Stefan Schreiber
- Department of Internal Medicine I, University Hospital Schleswig Holstein, Kiel University, Kiel, Germany
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- German Center for Lung Research (DZL), Frankfurt, Germany
| | - Peter Heuschmann
- Insitute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt,, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
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7
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Schwarz J, Ignatyev Y, Baum F, Neumann A, Soltmann B, Pfennig A, Timm J, Heinze M, von Peter S. [Flexible and integrative treatment in psychiatry: implementation of specific care components at model and standard care clinics in Germany (PsychCare study)]. Nervenarzt 2022; 93:476-482. [PMID: 34874468 PMCID: PMC9061660 DOI: 10.1007/s00115-021-01238-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since 2003 a new remuneration and care model has been implemented in currently 22 psychiatric clinics in Germany, which provides flexible and integrative treatment (FIT) across different settings of treatment, including assertive outreach care. The FIT is based on a global treatment budget covering costs for all psychiatric hospital services and is related to the number of patients treated per year. Previous research identified 11 program components that describe treatment structures and processes of FIT. The present analysis quantitatively compared FIT with standard care, aiming to validate these components. METHODS As part of the PsychCare study, grading according to FIT-specific components was carried out and comparatively analyzed in nine hospitals that used FIT and seven hospitals of standard care. The FIT models were examined in depth in subgroups, which were divided according to the share of the FIT model in the total hospital budget. RESULTS Of the 11 FIT program components 7 (flexible care management across settings, therapeutic group sessions across all settings, outreach home care, involvement of informal caregivers, accessibility of services, cooperation across sectors and expansion of professional expertise) showed a high statistical differentiation. These differences were even stronger in the subgroup of those hospitals that had a model contract with all health insurers. CONCLUSION Specific components of FIT are suitable for evaluating the quality of implementation of intersectoral, flexible and outreach psychiatric care.
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Affiliation(s)
- Julian Schwarz
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Seebad 82/83, 15562 Rüdersdorf, Deutschland
- Zentrum für Versorgungsforschung Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin, Deutschland
| | - Yuriy Ignatyev
- Zentrum für Versorgungsforschung Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin, Deutschland
| | - Fabian Baum
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Anne Neumann
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Bettina Soltmann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
| | - Andrea Pfennig
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
| | - Jürgen Timm
- Kompetenzzentrum für Klinische Studien Bremen, Universität Bremen, Bremen, Deutschland
| | - Martin Heinze
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Seebad 82/83, 15562 Rüdersdorf, Deutschland
- Zentrum für Versorgungsforschung Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin, Deutschland
| | - Sebastian von Peter
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Seebad 82/83, 15562 Rüdersdorf, Deutschland
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8
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Poulsen LK, Ilvig PM, Brendstrup L, Rasmussen CL, Pedersen KA, Ditlevsen P, Henriksen SE, Kirk JW. Development, implementation and evaluation of an optimized cross-sectoral rehabilitation program after acute hip fracture surgery: A mixed-methods study. Eval Program Plann 2022; 91:102021. [PMID: 34756708 DOI: 10.1016/j.evalprogplan.2021.102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
Fall-related hip fracture (HF) is a frequent trauma in Scandinavia with a yearly incidence of 8,000 among ≥65-year-old citizens in Denmark. The rising incidence and global predictions are alarming since a HF is a major, and potentially fatal, trauma to the citizen, requiring acute surgery, a multimodal approach and post-operative crosssectoral rehabilitation. However, continuity of the rehabilitation program is frequently interrupted in the transition between sectors, compromising optimal recovery of frail citizens. Thus, there is a need to develop and implement optimized cross-sectoral rehabilitation after HF. The purpose of this explorative study was to develop, implement and evaluate an optimized cross-sectoral rehabilitation program (OCRP) after HF surgery using validated theoretical frameworks. OCRP was developed, implemented and evaluated in one municipality using a pragmatic user-centered approach, quantitative and qualitative data collection and theoretical frameworks including the Behavior Change Wheel (BCW) and RE-AIM. Results of OCRP showed optimized rehabilitation based on motivated health professionals, high patient satisfaction and tendencies of improved levels of physical function. No re-referrals to rehabilitation were reported after OCRP. The BCW, RE-AIM and user-centered approach to program development, implementation and evaluation are useful to apply in program development and evaluation processes across sectors, professions, and medical specialties.
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Affiliation(s)
- Lise Kronborg Poulsen
- University College Copenhagen, Faculty of Health, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Education in Physiotherapy, Copenhagen, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Pia Maria Ilvig
- Rehabilitation Hvidovre, Hvidovre Municipality, Copenhagen, Denmark
| | | | | | | | - Peter Ditlevsen
- Department of Physiotherapy, Copenhagen University Hospital, Hvidovre, Denmark
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9
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Elsawah S, Hamilton SH, Jakeman AJ, Rothman D, Schweizer V, Trutnevyte E, Carlsen H, Drakes C, Frame B, Fu B, Guivarch C, Haasnoot M, Kemp-Benedict E, Kok K, Kosow H, Ryan M, van Delden H. Scenario processes for socio-environmental systems analysis of futures: A review of recent efforts and a salient research agenda for supporting decision making. Sci Total Environ 2020; 729:138393. [PMID: 32498149 DOI: 10.1016/j.scitotenv.2020.138393] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
This paper reviews the latest research on scenarios including the processes and products for socio-environmental systems (SES) analysis, modeling and decision making. A group of scenario researchers and practitioners participated in a workshop to discuss consolidation of existing research on the development and use of scenario analysis in exploring and understanding the interplay between human and environmental systems. This paper presents an extended overview of the workshop discussions and follow-up review work. It is structured around the essential challenges that are crucial to progress support of decision making and learning with respect to our highly uncertain socio-environmental futures. It identifies a practical research agenda where challenges are grouped according to the process stage at which they are most significant: before, during, and after the creation of the scenarios as products. These challenges for SES include: enhancing the role of stakeholder and public engagement in the co-development of scenarios, linking scenarios across multiple geographical, sectoral and temporal scales, improving the links between the qualitative and quantitative aspects of scenario analysis, addressing uncertainties especially surprise, addressing scenario diversity and their consistency together, communicating scenarios including visualization methods, and linking scenarios to decision making.
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Affiliation(s)
- Sondoss Elsawah
- Capability Systems Centre, University of New South Wales, Australian Defence Force Academy, Canberra, ACT, Australia; Institute for Water Futures, Fenner School of Environment and Society, Australian National University, Canberra, ACT, Australia.
| | - Serena H Hamilton
- Institute for Water Futures, Fenner School of Environment and Society, Australian National University, Canberra, ACT, Australia; CSIRO Land and Water, Canberra, ACT, Australia
| | - Anthony J Jakeman
- Institute for Water Futures, Fenner School of Environment and Society, Australian National University, Canberra, ACT, Australia
| | - Dale Rothman
- University of Denver, Josef Korbel School of International Studies, Denver, USA
| | - Vanessa Schweizer
- Department of Knowledge Integration, Faculty of Environment, University of Waterloo, Canada
| | - Evelina Trutnevyte
- Renewable Energy Systems, Institute for Environmental Sciences, Section of Earth and Environmental Sciences, University of Geneva, Switzerland
| | | | | | - Bob Frame
- Gateway Antarctica, University of Canterbury, Christchurch, New Zealand
| | - Baihua Fu
- Institute for Water Futures, Fenner School of Environment and Society, Australian National University, Canberra, ACT, Australia
| | | | - Marjolijn Haasnoot
- Deltares, Delft, the Netherlands; Utrecht University, Utrecht, the Netherlands
| | | | - Kasper Kok
- Environmental Systems Analysis Group, Wageningen University & Research, Wageningen, the Netherlands
| | - Hannah Kosow
- ZIRIUS - Research Center for Interdisciplinary Risk and Innovation Studies, University of Stuttgart, Germany
| | - Mike Ryan
- Capability Systems Centre, University of New South Wales, Australian Defence Force Academy, Canberra, ACT, Australia
| | - Hedwig van Delden
- Research Institute for Knowledge Systems (RIKS), Hertogsingel 11B, 6211 NC Maastricht, the Netherlands; School of Civil, Environmental and Mining Engineering, The University of Adelaide, Australia
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10
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Goebell PJ. [Sectoral interface-an opportunity for health services research?]. Urologe A 2020; 59:912-918. [PMID: 32638067 DOI: 10.1007/s00120-020-01260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The request for increased outpatient care is currently widely discussed in healthcare debates. With that, the sectoral interface (outpatient/hospital) is receiving greater attention, which provides an incentive for better cooperation and coordination of all healthcare providers. This also marks an opportunity to establish new cross-sectoral structures-also for research. The definitions of cross-sectoral care and the research content need to be in a standardized and consolidated manner. The provision of treatment data along the entire patent's path remains essential for health services research. In this context, the cross-sectoral interface could be regarded as fragile in that it is particularly sensitive to disruptions. The current increasing digitalization can also be seen as an opportunity to minimize the loss of information through the further development of cross-sectoral structures and to improve patient care, while simultaneously making a contribution to research across sectoral borders.
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Affiliation(s)
- P J Goebell
- Urologische und Kinderurologische Universitätsklinik, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
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11
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Laurie GT. Cross-Sectoral Big Data: The Application of an Ethics Framework for Big Data in Health and Research. Asian Bioeth Rev 2019; 11:327-339. [PMID: 31632475 PMCID: PMC6779678 DOI: 10.1007/s41649-019-00093-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/25/2022] Open
Abstract
Discussion of uses of biomedical data often proceeds on the assumption that the data are generated and shared solely or largely within the health sector. However, this assumption must be challenged because increasingly large amounts of health and well-being data are being gathered and deployed in cross-sectoral contexts such as social media and through the internet of (medical) things and wearable devices. Cross-sectoral sharing of data thus refers to the generation, use and linkage of biomedical data beyond the health sector. This paper considers the challenges that arise from this phenomenon. If we are to benefit fully, it is important to consider which ethical values are at stake and to reflect on ways to resolve emerging ethical issues across ecosystems where values, laws and cultures might be quite distinct. In considering such issues, this paper applies the deliberative balancing approach of the Ethics Framework for Big Data in Health and Research (Xafis et al. 2019) to the domain of cross-sectoral big data. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end.
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Affiliation(s)
- Graeme T. Laurie
- School of Law and JK Mason Institute for Medicine, Life Sciences and the Law, University of Edinburgh, Edinburgh, UK
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12
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von Peter S, Ignatyev Y, Indefrey S, Johne J, Schwarz J, Timm J, Heinze M. [Specific components for integrative and flexible care models according to § 64b SGB V]. Nervenarzt 2019; 89:559-564. [PMID: 29209751 DOI: 10.1007/s00115-017-0459-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is a need for a theoretical model for evaluating integrative and flexible care models according to § 64b of the Social Security Statutes Book V (SGB V). MATERIAL AND METHODS An iterative process of data collection and analysis has been executed according to grounded theory methodology. RESULTS A total of 11 specific components have been identified and shown to be robust and practicable and compatible with the data from the literature. CONCLUSION These components can be used for implementation, quality management and evaluation of projects for treatment models according to § 64b SGB V.
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Affiliation(s)
- S von Peter
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Straße 5-11, 14055, Berlin, Deutschland.
| | - Y Ignatyev
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Rüdersdorf, Deutschland
| | - S Indefrey
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Straße 5-11, 14055, Berlin, Deutschland
| | - J Johne
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Straße 5-11, 14055, Berlin, Deutschland
| | - J Schwarz
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Rüdersdorf, Deutschland
| | - J Timm
- Kompetenzzentrum für Klinische Studien Bremen, Universität Bremen, Bremen, Deutschland
| | - M Heinze
- Immanuel Klinik Rüdersdorf, Hochschulklinik für Psychiatrie und Psychotherapie der Medizinischen Hochschule Brandenburg, Rüdersdorf, Deutschland
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13
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Henderson JL, Chaim G, Hawke LD. Screening for substance use and mental health problems in a cross-sectoral sample of Canadian youth. Int J Ment Health Syst 2017; 11:21. [PMID: 28261324 PMCID: PMC5331633 DOI: 10.1186/s13033-017-0128-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/22/2017] [Indexed: 01/08/2023] Open
Abstract
Background This project examines the substance use and mental health concerns of a cross-sectoral, national, service-seeking sample of adolescents and emerging adults using an extended version of the Global Appraisal of Individual Needs-Short Screener (GSS). It also aims to provide incremental evidence of the psychometric properties of the GSS. Methods A sample of 2313 youth aged 12–24 years who presented for service participated in the project. Youth were recruited from 89 participating services across Canada representing eight major clinical and non-clinical sectors. Participants completed the GSS and provided sociodemographic data. Results The majority of youth presenting for services endorsed concerns on the GSS and would be likely to meet diagnostic criteria for a disorder in a full diagnostic assessment according to the norms for the scale, while many endorsed multiple concerns. This was true in both clinical and non-clinical settings. Externalizing concerns and suicidality were significantly more common in younger participants, while substance use was significantly more common in older youth. Females were more likely to endorse internalizing and suicidality concerns, while males endorsed more substance use and crime/violence concerns. Internalizing and suicidality concerns were also more common in Canada’s northerly regions. The reliability of the GSS was confirmed, however the factor structure revealed problems. Conclusions Youth presenting across clinical and non-clinical service sectors endorse high levels of need, supporting the importance of universal, cross-sectoral screening. The GSS is a practical tool that service providers across sectors can employ to identify the addiction and mental health service needs of youth, although further psychometric work is warranted. Implications for screening and treatment in community contexts are discussed.
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Affiliation(s)
- Joanna L Henderson
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada.,University of Toronto, 250 College Street, Toronto, ON M5T 1R8 USA
| | - Gloria Chaim
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada.,University of Toronto, 250 College Street, Toronto, ON M5T 1R8 USA
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
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14
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McPherson C, Ploeg J, Edwards N, Ciliska D, Sword W. A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada. BMC Health Serv Res 2017; 17:100. [PMID: 28143621 PMCID: PMC5286844 DOI: 10.1186/s12913-017-2018-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/16/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine key processes and supportive and inhibiting factors involved in the development, evolution, and sustainability of a child health network in rural Canada. This study contributes to a relatively new research agenda aimed at understanding inter-organizational and cross-sectoral health networks. These networks encourage collaboration focusing on complex issues impacting health - issues that individual agencies cannot effectively address alone. This paper presents an overview of the study findings. METHODS An explanatory qualitative case study approach examined the Network's 13-year lifespan. Data sources were documents and Network members, including regional and 71 provincial senior managers from 11 child and youth service sectors. Data were collected through 34 individual interviews and a review of 127 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. RESULTS Three themes related to network development, evolution and sustainability were identified: (a) Network relationships as system triggers, (b) Network-mediated system responsiveness, and (c) Network practice as political. CONCLUSIONS Study findings have important implications for network organizational development, collaborative practice, interprofessional education, public policy, and public system responsiveness research. Findings suggest it is important to explicitly focus on relationships and multi-level socio-political contexts, such as supportive policy environments, in understanding health networks. The dynamic interplay among the Network members; central supportive and inhibiting factors; and micro-, meso-, and macro-organizational contexts was identified.
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Affiliation(s)
- Charmaine McPherson
- School of Nursing, Faculty of Science, St. Francis Xavier University, Box 5000, Antigonish, Nova Scotia B2G 2W5 Canada
| | - Jenny Ploeg
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada
| | - Nancy Edwards
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario KlH 8M5 Canada
| | - Donna Ciliska
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada
| | - Wendy Sword
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario KlH 8M5 Canada
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