Showing papers by "Danube University Krems published in 2009"
TL;DR: Investigation of interspecific, interannual, and geographic variability in the diets and trophic positions of calanoid copepod species in the Strait of Georgia using a combination of fatty acids and stable isotopes finds that regardless of variability in food quality, the relative tro PH positions of these copepods do not change significantly.
Abstract: The spring zooplankton community in the Strait of Georgia (British Columbia, Canada) is characterized by the presence of several calanoid copepod species which collectively make up ~90% of the mezozooplankton biomass. Here, we investigate interspecific, interannual, and geographic variability in the diets and trophic positions of these copepods using a combination of fatty acids and stable isotopes. To characterize geographic variability in diet, we compare our findings from the Strait of Georgia with similar data from Ocean Station P in the subarctic northeast Pacific. Both fatty acid and stable isotope signatures indicate the existence of three trophic levels, even within the limited size range of these copepods: Neocalanus plumchrus and Calanus marshallae are primarily omnivorous, while Euchaeta elongata is carnivorous and Eucalanus bungii is herbivorous. Fatty acid markers of trophic position (e.g., DHA/EPA, 18:1n-9/18:1n-7) correlate significantly with δ15N, while markers indicating the proportion of diatoms to flagellates in the diet (e.g., 16PUFA/18PUFA and DHA/EPA) correlate significantly with δ13C, after the effect of lipid concentration on δ13C is accounted for. Despite the general correlation between stable isotopes and fatty acids, the former are not sensitive enough to capture the range of interannual variability observed in the latter, and can only capture substantial shifts in the diet over geographic scales. However, regardless of variability in food quality, the relative trophic positions of these copepods do not change significantly either spatially or temporally.
125 citations
TL;DR: Hyalograft C autograft provides clinical improvement in healthy young patients with single cartilage defects in patients with osteoarthritis and less complicated surgery and lower morbidity are considered advantages of the technique.
Abstract: BackgroundTissue engineering has become available for cartilage repair in clinical practice.HypothesisThe treatment of full-thickness chondral defects in the knee with a hyaluronan-based scaffold s...
113 citations
TL;DR: The authors examined the defining features of emerging adulthood, subjects' conceptions of the transition to adulthood, and the perceived adult status in Austria and found that most Austrian emerging adults feel themselves to be between adolescence and adulthood.
Abstract: The present study examined the defining features of emerging adulthood, subjects' conceptions of the transition to adulthood, and the perceived adult status in Austria. The sample consisted of 775 subjects (226 adolescents, 317 emerging adults, 232 adults). Results showed that most Austrian emerging adults feel themselves to be between adolescence and adulthood. Emerging adults predominantly described this period as an age of possibilities and identity exploration, as a self-focused age, as an age of feeling in between, and of instability. Regarding important criteria for feeling adult, it was found that age groups (adolescents, emerging adults, adults) differ in individualism, family capacities, norm compliance, role transitions, and other. Thus, as was shown for other Western cultures, emerging adulthood seemed to constitute a distinct stage of life in Austria also.
78 citations
TL;DR: These European Federation of Neurological Sciences guidelines are designed to provide practical help for the general neurologist to make appropriate use of molecular genetics for diagnosing mitochondrial disorders (MIDs), which gain increasing attention and are more frequently diagnosed due to improved diagnostic tools.
Abstract: Objectives: These European Federation of Neurological Sciences (EFNS) guidelines are designed to provide practical help for the general neurologist to make appropriate use of molecular genetics for diagnosing mitochondrial disorders (MIDs), which gain increasing attention and are more frequently diagnosed due to improved diagnostic tools.
Background: Since the publication of the first EFNS guidelines on the molecular diagnosis of inherited neurological diseases in 2001, rapid progress has been made in this field, necessitating the creation of an updated version.
Search strategy: To collect data about the molecular diagnosis of MIDs search for literature in various electronic databases, such as Cochrane library, MEDLINE, OMIM, GENETEST or Embase, were carried out and original papers, meta-analyses, review papers, and guideline recommendations were reviewed.
Results: The guidelines summarise the possibilities and limitations of molecular genetic diagnosis of MIDs and provide practical recommendations and diagnostic criteria in accordance with the EFNS Scientific Committee to guide the molecular diagnostic work-up of MIDs.
Recommendations: The proposed guidelines suggest an approach to the molecular diagnosis of MIDs in a manner accessible to general neurologists.
65 citations
Book•
03 Jun 2009TL;DR: This paper implemented a number of methods within the MediaWiki system, where social rewarding criteria are satisfied by generating a ranking of most active members, which aims to meet the needs of users.
Abstract: Online communities have something in common: their success rise and fall with the participation rate of active users. In this paper we focus on social rewarding mechanisms that generate benefits for users in order to achieve a higher contribution rate in a wiki system. In an online community, social rewarding is in the majority of cases based on accentuation of the most active members. As money cannot be used as a motivating factor others like status, power, acceptance, and glory have to be employed. We explain different social rewarding mechanisms which aim to meet these needs of users. Furthermore, we implemented a number of methods within the MediaWiki system, where social rewarding criteria are satisfied by generating a ranking of most active members.
61 citations
TL;DR: Most of the available evidence regarding the efficacy and safety of BFRs has a high risk of bias, and it is concluded that, based on the reported adverse events in these six trials, B FRs are probably safe.
Abstract: Bach Flower Remedies are thought to help balance emotional state and are commonly recommended by practitioners for psychological problems and pain. We assessed whether Bach Flower Remedies (BFRs) are safe and efficacious for these indications by performing a systematic review of the literature. We searched MEDLINE®, Embase, AMED, and the Cochrane Library from inception until June 2008 and performed a hand-search of references from relevant key articles. For efficacy, we included all prospective studies with a control group. For safety, we also included retrospective, observational studies with more than 30 subjects. Two authors abstracted data and determined risk of bias using a recognised rating system of trial quality. Four randomised controlled trials (RCTs) and two additional retrospective, observational studies were identified and included in the review. Three RCTs of BFRs for students with examination anxiety, and one RCT of BFRs for children with attention-deficit hyperactivity disorder (ADHD) showed no overall benefit in comparison to placebo. Due to the number and quality of the studies the strength of the evidence is low or very low. We did not find any controlled prospective studies regarding the efficacy of BFRs for pain. Only four of the six studies included for safety explicitly reported adverse events. Most of the available evidence regarding the efficacy and safety of BFRs has a high risk of bias. We conclude that, based on the reported adverse events in these six trials, BFRs are probably safe. Few controlled prospective trials of BFRs for psychological problems and pain exist. Our analysis of the four controlled trials of BFRs for examination anxiety and ADHD indicates that there is no evidence of benefit compared with a placebo intervention.
53 citations
TL;DR: A simple, time-saving, but effective method called LASSIE is proposed to formalize new guideline versions of previously formalized CPGs to provide up-to-date knowledge necessary for accomplishing the daily work of health care professionals.
52 citations
TL;DR: An ultra-low-power and low-cost wireless temperature data logger system is presented with its application in observing dental retainer use and results of the first clinical trials observing the patient's dental retainers equipped with the RFID temperature sensor/data logger device are presented.
Abstract: In this paper, a wireless interrogable sensor device based on an ultra low-power microcontroller for data collection and a radio frequency identification (RFID) interface for data transmission is presented. Wireless sensor systems utilizing RFID transponders offer a new and exciting means of measurement and identification suitable for many biomedical applications. For the majority of these applications, small, inexpensive radio request sensor systems are desirable. In this paper, an ultra-low-power and low-cost wireless temperature data logger system is presented with its application in observing dental retainer use. For this purpose, the retainer's ambient temperature is measured by an integrated sensor and recorded using a microcontroller which acts like a temperature data logger storing the thermal history of several months. For a self powered wireless data transmission from the sensor to the interrogation unit a RFID transponder, operating in the 13.56 MHz ISM band, is used. The presented sensor system includes hard- and software power saving modes reducing the sensor idle current consumption to 1 muA. This allows a battery powered operation of the device for up to two years. For dental and biomedical applications, the device is hermetically sealed using a biocompatible polymeric encapsulation. Results of the first clinical trials observing the patient's dental retainer usage by a set of retainers equipped with the RFID temperature sensor/data logger device are presented. The stored temperature values are analyzed and a clear temperature characteristic indicating the retainer usage was found.
50 citations
TL;DR: This work proposes a three-level methodology to make more out of users' insights in the field of visual analytics, and helps to understand how insights emerge and build on one each other.
Abstract: For evaluating visual-analytics tools, many studies confine to scoring user insights into data. For participatory design of those tools, we propose a three-level methodology to make more out of users' insights. The relational insight organizer (RIO) helps to understand how insights emerge and build on one each other. In recent years, computers have also been used to develop visual methods and tools that further support the data analysis process. With the advent of the emerging field of visual analytics (VA), the underlying concept of visual tools is taken a step further. In essence, VA combines human analytical capabilities with computer processing capacities. In the human-computer interaction process, the user generates new knowledge and gains insights.
43 citations
TL;DR: A structured method for quantitatively dealing with drug dose in comparative effectiveness reviews is described, with application to the second-generation antidepressants, and dose-dependent reductions in HAM-D scores were identified, although differences did not translate into better response rates for higher doses.
Abstract: Purpose . To describe a method for quantitatively dealing with drug dose in comparative effectiveness reviews. Second-generation antidepressants are used as an example to illustrate this method and to determine whether dose influences conclusions on comparative effectiveness.Methods. Studies previously identified in a systematic review of second-generation antidepressants were included if data on drug dose were available. The usual dosing range for each drug was defined and then used to create 2- and 3-level dose categories. Placebo-controlled data were used to calculate overall effect sizes for the drug class and effect sizes stratified by drug dose. Meta-regression tested the impact of dose on effect size. Weighted mean differences and risk ratios were calculated for comparative studies, stratifying by whether compared doses were equivalent.Results. The dose classification method was able to identify dose-response trends in the context of meta-analysis. Compared to low-dose studies, medium- and high-dos...
41 citations
15 Jul 2009
TL;DR: GROOVE uses different techniques to visualize time-oriented data by overlaying several time granularities in one visualization and provides interactive operators, which utilize the structures of time in different ways to capture and explore time- oriented data.
Abstract: Many real-world problems involve time-oriented data. Time data is different from other kinds of data--explicitly harnessing the structures of time in visualizations can guide and support users’ visual analysis processes. State-of-the-art visualizations hardly take advantage of the structures of time to aid users in understanding and exploring the data. To bring more flexibility to the analysis process, we have developed interactive visual methods incorporating the structures of time within a pixel-based visualization called GROOVE (granular overview overlay). GROOVE uses different techniques to visualize time-oriented data by overlaying several time granularities in one visualization and provides interactive operators, which utilize the structures of time in different ways to capture and explore time-oriented data.
TL;DR: The concept and the preliminary results of a research project which was conducted to evaluate E-Portfolio software are described, which recommendations can be made to an institution which now wants to implement electronic portfolios with a certain objective.
Abstract: E-Portfolios are a new type of software and it is still relatively vague to determine, which functions are obligatory â?? that is which functions constitute characteristic features â?? and which functions are just optional (â??nice to haveâ??). This article describes the concept and the preliminary results of a research project which was conducted to evaluate E-Portfolio software, and aims at providing decision guidance for implementing E-Portfolios in higher education - first and foremost from the pedagogical perspective. Which recommendations can be made to an institution which now wants to implement electronic portfolios with a certain objective?
TL;DR: The most effective strategy for the treatment of SLEs appears to be the application of L‐arginine, coenzyme‐Q, steroids, edaravone, creatine‐monohydrate, or dichloracetate, which is a dominant feature of some syndromic or non‐syndromic MIDs.
Abstract: Aim of this review is to discuss recent findings concerning the management of stroke-like episodes (SLEs) in patients with mitochondrial disorders (MIDs). Various databases were searched for appropriate literature. SLEs are a dominant feature of MIDs and occur most frequently in MELAS-syndrome, less frequently in MERRF-syndrome, Kearns-Sayre-syndrome, or Leigh-syndrome. SLEs occur at all ages and are frequently accompanied by other cerebral abnormalities. Clinically, SLEs mimic ischemic stroke but not on imaging studies and concerning the management. The morphological equivalent on MRI is the stroke-like-lesion, representing a vasogenic edema (hyperintensity on T2, diffusion-weighted imaging and apparent diffusion coefficient in the acute and subacute or chronic stage, most frequently in the parieto-occipital region, surpassing vascular territories). For diagnostic and therapeutic reasons SLEs need to be clearly delineated from ischemic stroke and cerebral bleeding. Though there is no causal therapy available, symptomatic and general measures can help to resolve the clinical manifestations. In conclusion this review shows that SLEs are a dominant feature of some syndromic or non-syndromic MIDs. The most effective strategy for the treatment of SLEs appears to be the application of L-arginine, coenzyme-Q, steroids, edaravone, creatine-monohydrate, or dichloracetate.
TL;DR: It is argued that advanced technologies have specific potentials to support all forms of visitor-to-visitor knowledge communication and, furthermore, allow for new forms of knowledge communication among unacquainted visitors and beyond the actual museum visit.
TL;DR: Anakinra is an effective drug for treating RA and indirect comparisons with adalimumab, etanercept and infliximab, however, showed a trend towards greater efficacy for the anti-TNF drugs.
Abstract: Objective
To systematically review the general and comparative efficacy and safety of anakinra for rheumatoid arthritis.
TL;DR: Current evidence does not warrant the choice of duloxetine over other second-generation antidepressants based on greater efficacy or safety for patients with acute-phase MDD with or without accompanying symptoms such as pain.
Abstract: Background: Second-generation antidepressants dominate the management of patients with major depressive disorder (MDD). Evidence on the general and comparative benefits and harms is still accruing. Objective: To systematically review the general and comparative efficacy and safety of duloxetine for the treatment of acute-phase MDD in adults. Data Sources: We conducted a search of MEDLINE, Embase, PsychLit, The Cochrane Library, and the International Pharmaceutical Abstracts from 1980 to July 2009, as well as manually searching reference lists of pertinent review articles and exploring the Center for Drug Evaluation and Research database to identify unpublished research. Study Selection: For efficacy, randomized controlled trials (RCTs) comparing duloxetine with placebo or second-generation antidepressants were included. For safety, both experimental and observational studies were eligible. Data Extraction: Abstracts and full-text articles were independently reviewed by two people, one investigator extracted relevant data, and a senior reviewer checked data for completeness and accuracy. Results: We included 36 experimental and observational studies and, where sufficient data were available, meta-analyses of RCTs were conducted. Findings indicated that duloxetine is an effective treatment option for acute-phase MDD, with a tolerability profile similar to other second-generation antidepressants. No substantial differences in efficacy and safety appear to exist when duloxetine is compared with other second-generation antidepressants. Overall, about 40% of patients treated with duloxetine achieved remission. Compared with other treatments, duloxetine had frequently higher rates of nausea, vomiting and dry mouth; however, these differences did not lead to higher discontinuation rates compared with selective serotonin reuptake inhibitors as a class. There is insufficient evidence to draw conclusions about rare but severe adverse events. Conclusions: Current evidence does not warrant the choice of duloxetine over other second-generation antidepressants based on greater efficacy or safety for patients with acute-phase MDD with or without accompanying symptoms such as pain.
TL;DR: The outcome indicated an effective apical obturation using any of the three materials in combination with a noncompaction technique.
21 Jul 2009
TL;DR: This paper describes the building of a prescriptive DSS based on breast cancer treatment protocols and its integration with a legacy Electronic Patient Record, and how semantic wiki technology was used for the encoding task.
Abstract: A computerized Decision Support Systems (DSS) can improve the adherence of the clinicians to clinical guidelines and protocols The building of a prescriptive DSS based on breast cancer treatment protocols and its integration with a legacy Electronic Patient Record is the aim of the Oncocure project An important task of this project is the encoding of the protocols in computer-executable form -- a task that requires the collaboration of physicians and computer scientists in a distributed environment In this paper, we describe our project and how semantic wiki technology was used for the encoding task Semantic wiki technology features great flexibility, allowing to mix unstructured information and semantic annotations, and to automatically generate the final model with minimal adaptation cost These features render semantic wikis natural candidates for small to medium scale modeling tasks, where the adaptation and training effort of bigger systems cannot be justified This approach is not constrained to a specific protocol modeling language, but can be used as a collaborative tool for other languages When implemented, our DSS is expected to reduce the cost of care while improving the adherence to the guideline and the quality of the documentation
TL;DR: Substantial shortcomings in reporting exist in aspects of study design important to determine whether a study is applicable to specific populations of interest.
Abstract: Background: Uncertainty about the applicability of controlled trial findings is an increasing concern for clinicians and policy decision makers. This study aimed to determine whether information reported in studies included in systematic reviews was adequate enough to assess their applicability. Methods: We used the databases of four recently conducted systematic reviews on the comparative efficacy and safety of second-generation antidepressants, inhaled corticosteroids, Alzheimer's drugs, and targeted immune modulators. We developed and pilot-tested a questionnaire to assess the adequacy of reporting with respect to seven previously validated criteria of study design that distinguish explanatory from pragmatic studies. For each of the 137 included studies, two reviewers independently assessed the adequacy of reporting. Results: Overall, only 12 percent of the included studies provided sufficient information to reliably distinguish explanatory from pragmatic studies. The areas with the greatest lack of reporting were the setting of the study, methods of adverse event assessment, and sample size considerations to determine a minimally important difference from a patient perspective. Conclusions: Substantial shortcomings in reporting exist in aspects of study design important to determine whether a study is applicable to specific populations of interest.
TL;DR: In Austria, two recent eParticipation projects focused on adolescent citizens indicate that web portals and eParticpation seems to suit the adolescents' information and communication needs.
Abstract: In Austria, two recent eParticipation projects focused on adolescent citizens. The first project, "mitmachen.at --- move your future" was to provide initial experiences with an eParticipation tool. The second project, "Jugend2help", applied the lessons learned from the "mitmachen.at" project to improve the Austrian public administration web portal for adolescent citizens. In both projects, the results indicate that web portals and eParticpation seems to suit the adolescents' information and communication needs. Involving the users is central to the development of an eParticipation process or platform so that the users' specific characteristics (age, skills), needs and interests are included appropriately. The target users' characteristics are also important for developing a marketing strategy which is able to reach them. Other issues which must also be considered in eParticipation are accessibility, inclusion and possibly gender.
TL;DR: Alginate microcapsules containing C3A cells can be used to produce albumin and growth factors in a bioartificial or hybrid liver support system due to their small diameter and the high flow rate in a dynamic model has no influence on the survival and metabolic activities of the encapsulated cells.
Abstract: PurposeThe aim of this study was to encapsulate C3A cells into alginate microcapsules with an average diameter of ≤ 100 μm, thus enabling them to be recirculated in a bioartificial liver device bas...
08 Dec 2009
TL;DR: A novel approach for an on demand routing protocol using sensor attractiveness-metric (Pa) gradients for the data forwarding decisions is proposed, which is a lightweight approach to generalized multihop routing algorithms in WSNs.
Abstract: A novel approach for an on demand routing protocol using sensor attractiveness-metric (P a ) gradients for the data forwarding decisions is proposed. Attractiveness based routing provides an efficient concept for a data-centric routing in wireless sensor networks. The protocol works on-demand, is source-initiated, has a flat hierarchy and has its origin in the idea of pheromone based routing. During development of the algorithm, the attractiveness-metric was turned into a special factor for link costs and is the sole determinant for data load propagation where the attractiveness level of the sensor node defines its data forwarding attitude. The link costs called “attractiveness” are calculated from the sensor nodes' energy status, the current buffer (sensor on board memory) fill level. The received signal strength can also take into account for the attractiveness metric calculation. The algorithm only supports node-to-sink data traffic and therefore is a lightweight approach to generalized multihop routing algorithms in WSNs. The performance evaluation of the proposed protocol is done by extensive simulation using a multi-agent based simulation environment called NetLogo.
19 Jul 2009
TL;DR: This paper describes how to handle the challenge of mapping a breast cancer treatment protocol encoded in Asbru to a legacy EPR which has been used by oncologists at the point of care for years.
Abstract: Clinical protocols can improve the quality of care if implemented in Decision Support Systems (DSS) that are used in clinical practice. For optimal user acceptance, they must use data from the existing Electronic Patient Records (EPR) and enforce only small changes in the care process and minimal extra effort for data entry. In this paper we describe how we handle the challenge of mapping a breast cancer treatment protocol encoded in Asbru to a legacy EPR which has been used by oncologists at the point of care for years. We identified different levels of integration effort ranging from readily available data in the EPR to abstractions which can only be performed by domain experts. By involving the author of the protocol in the implementation process, we were able to design a system which promises to improve the daily routine at the places of application.
TL;DR: An analysis of 12 different second-generation antidepressants rated sertraline and escitalopram as having the most favorable balance between benefit and harm for the treatment of major depressive disorder in adults.
Abstract: An analysis of 12 different second-generation antidepressants rated sertraline and escitalopram as having the most favorable balance between benefit and harm for the treatment of major depressive disorder in adults. A second look at the methods and results from the study reveals that such a positive conclusion might not be warranted.
20 Sep 2009
TL;DR: A simplified design for an on demand routing protocol using pheromone (attractiveness) gradients for data forwarding decisions is proposed, which provides an easy concept for a data-centric routing protocol in wireless sensor networks.
Abstract: A simplified design for an on demand routing protocol using pheromone (attractiveness) gradients for data forwarding decisions is proposed. The developed Pheromone-based Routing Strategy (PRS) provides an easy concept for a data-centric routing protocol in wireless sensor networks. The protocol has a flat hierarchy, works on-demand, is source-initiated and has its origin in the idea of ant-based routing. During development of PRS, the important variable pheromone was turned into a special factor for link costs and is the sole determinant for data load propagation where the pheromone level of the sensor node defines its attractiveness for forwarding data. The link costs called pheromone are calculated from the sensor nodes’ energy status, as well as the received signal strength and the current buffer (sensor on board memory) fill level. PRS only supports node-to-sink data traffic and therefore is a lightweight approach to generalized multihop routing algorithms in WSNs. The PRS routing protocol is implemented on a MSP430F149 low power microcontroller using a CC2420 wireless interface which are acting together as a sensor node. For performance evaluation of PRS a multi-agent based simulation environment called NetLogo is used.
Proceedings Article•
01 Jan 2009TL;DR: This work builds a prescriptive CDSS that is expected to reduce the cost of care while improving the adherence to the guideline and the quality of the documentation and can be generalized to other fields of medicine and patient management systems.
Abstract: A computerized Decision Support System (CDSS) can improve the adherence of the clinicians to clinical guidelines and protocols. Integrating it within the clinical workflow can reduce the workload of the physicians, and improve the acceptance of the system. The building of a prescriptive CDSS and its integration with a legacy cancer patient management system is the aim of the Oncocure project, which implements the existing protocol for the medical treatment of breast cancer in the Asbru language, and interfaces the Asbru interpreter with the Electronic Patient Record (EPR) in use in an oncologic unit. Our work is not constrained to a specific domain or EPR implementation, but can be generalized to other fields of medicine and patient management systems. When implemented, our CDSS is expected to reduce the cost of care while improving the adherence to the guideline and the quality of the documentation.
TL;DR: Results from observations and interviews within the research project InnoMat are presented to answer the question how self-efficacy influences the ticket buying behavior and show that this motivational factor leads to an active avoidance of ticket machines.
Abstract: Many subgroups in today's society are not skilled in using novel technologies. Even everyday technologies pose a barrier to technically non-skilled people and --- if they fail to use them --- exclude them from important parts of daily life. In this paper we discuss the relevance of self-efficacy for the use of one specific kind of everyday technology: the ticket vending machine. Results from observations and interviews within the research project InnoMat are presented to answer the question how self-efficacy influences the ticket buying behavior and show that this motivational factor leads to an active avoidance of ticket machines. Negative experiences seem to be one of the strongest influences, which indicate that the group of technically non-skilled users should be given special attention when developing a new generation of ticket vending machines.
Proceedings Article•
01 Jan 2009
TL;DR: The modelling and execution of CGPs are described in Asbru within the EU project Remine, which develops a high-performance platform for the prediction, detection and monitoring of RAPS.
Abstract: The detection and prevention of Risks Against Patient Safety (RAPS) are ever-increasing issues in health care. One aspect of the many measures taken against RAPS is the comparison of the actual care practice against descriptions of best practice given in clinical guidelines and protocols (CGPs). In order to perform such comparisons automatically, CGPs need to be modelled in a computer- executable form. In addition, the execution of the CGP model must be integrated with the care process at the site of application, and with risk-assessment tools used by the hospital's risk manager to explore what-if scenarios. In this paper, we describe the modelling and execution of CGPs in Asbru within the EU project Remine, which develops a high-performance platform for the prediction, detection and monitoring of RAPS.
TL;DR: The study addressed an ongoing challenge for clinicians: how to choose among antidepressant treatments and select the best drug for an individual patient suffering from an episode of major depression.
Abstract: Primary care physicians and psychiatrists manage the majority of patients suffering from acute phase major depressive disorder (MDD). For most patients, antidepressant treatment is the primary choice of care. Second generation antidepressants (SGAs)—developed following the first generation of tricyclic and monoamine oxidase agents—have become the preferred drug choice because of their greater tolerability, lower risk of lethality and similar efficacy compared with first generation agents.
Clinicians prescribing SGAs face a multitude of drug choices and are the target of extensive marketing campaigns by the pharmaceutical industry. In 2007, three of the 20 top selling drugs in the USA were antidepressants with annual sales ranging from $2.3 billion (venlafaxine XR (Effexor XR)) to $1.4 billion (duloxetine (Cymbalta)).1 At the time of writing, 13 different SGAs have been approved for the treatment of major depression in the USA and Canada and two additional drugs (reboxetine, milnacipran) are available in some European countries. Some of these drugs are now available as generic medications, others are still patent protected. Economically, drug choice matters. The US Consumers Union found that in 2008 the average monthly costs of treatment with second generation antidepressants in the USA varied from $20 to $400 depending on the medication of choice.2 The study conducted by Cipriani and colleagues3 addressed an ongoing challenge for clinicians: how to choose among antidepressant treatments and select the best drug for an individual patient suffering from an episode of major depression ( see page 107 ).
The burning question for patients and clinicians is whether differences in costs are substantiated by differences in benefits and harms. Evidence based data to answer this question and to guide selection of treatments has been limited. Because of the lack of available direct head to head comparisons, prior systematic reviews have been able to say little about …
TL;DR: It is possible to observe a mobile dental service for patients of austrian geriatric nursing homes does exist, however, noMobile dental service was identified for austrian home bound patients, which shows the need for a mobile dentist care programme and politcs.
Abstract: Objectives: To investigate the existence and the quality of mobile dental services available to the austrian elderly population of Lower Austria, Austria, using two approaches: the home-bound elders’ perception and the dentistry services provided in nursery homes.
Methods: The study had two parts. The first was a qualitative assessment of mobile dental services as perceived by the elderly home bounds, based on 52 questionnaires. These questionnaries were distributed to the home bound persons in a period of one month. The second part was the assessment in the nursing homes. For this study a short questionnaire was sent, by e-mail, to 61 nursing homes of Lower Austria.
Results: by the elderly home bound - 29 questionnaires returned completed (response quote of 55.8%) and 4 uncompleted. The age range of the subjects was from 64 to 89 years old and the ratio of women to men was about 2:1 (62% to 38%). 79.3% think that dental home care is a good practice, 58.6% would use mobile dentistry themselves. in the nursing homes - From the 61 sent e-mails 33 were returned with completed questionnaires (response quote of 54.09%). 48.5% of the nursing homes replied that they do not have mobile dental service. However, 17 homes (51.51%) have a mobile dentist.
Conclusion: A mobile dental service for patients of austrian geriatric nursing homes does exist. However, no mobile dental service was identified for austrian home bound patients. This scenario shows the need for a mobile dental care programme and politcs.
Executive Summary
This study was carried out to identify what the current situation is with mobile dentistry in the State of Lower Austria, Austria, using two approaches: the home-bound elders’ perception and the dentistry services provided in nursery homes. The aim was to investigate the existence and the quality of mobile dental services available to the austrian elderly population of Lower Austria. Based on this study, it is possible to observe a mobile dental service for patients of austrian geriatric nursing homes does exist. However, no mobile dental service was identified for austrian home bound patients. This scenario shows the need for a mobile dental care programme and politcs.