Danube University Krems

About: Danube University Krems is a education organization based out in Krems, Niederösterreich, Austria. It is known for research contribution in the topics: Stroke & Population. The organization has 498 authors who have published 1572 publications receiving 68797 citations.

Cost-effectiveness analysis of online hemodiafiltration versus high-flux hemodialysis.

Abstract: Background Clinical studies suggest that hemodiafiltration (HDF) may lead to better clinical outcomes than high-flux hemodialysis (HF-HD), but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD. Methods The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1) estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2) simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3) application of state-specific health-related quality of life coefficients and differential costs derived from the literature. Several Monte Carlo simulations were performed, including simulations for patients with different risk profiles, for example, by age (patients aged 40, 50, and 60 years), sex, and diabetic status. Scatter plots of simulations in the cost-effectiveness plane were produced, incremental cost-effectiveness ratios were estimated, and cost-effectiveness acceptability curves were computed. Results An incremental cost-effectiveness ratio of €6,982/quality-adjusted life years (QALY) was estimated for the baseline cohort of 50-year-old male patients. Given the commonly accepted threshold of €40,000/QALY, HDF is cost-effective. The probabilistic sensitivity analysis showed that HDF is cost-effective with a probability of ~81% at a threshold of €40,000/QALY. It is fundamental to measure the outcome also in terms of quality of life. HDF is more cost-effective for younger patients. Conclusion HDF can be considered cost-effective compared to HF-HD.

Sustainability of local government debt: a case study of Austrian municipalities

Abstract: Austrian municipalities face manifold challenges with respect the sustainability of their budgetary policies, especially concerning public (municipal) debt. On the one hand, municipalities are closely monitored and supervised by upper-level governments. Local borrowing is confined to pre-defined cases with respect to extra-ordinary expenditure. Both dimensions come close to constitute an at least soft debt limit (budget constraint) for municipalities. On the other hand, municipal discretion over expenditure and revenue is limited. In the current paper, we test whether municipalities’ budgetary policies were sustainable by means of an adapted version of Bohn’s (Q J Econ 113:949–963, 1998) sustainability test. We find that municipal debt limits were quite effective and resulted in stationary debt levels, and in significant and sufficient reactions of the municipal primary surplus to increasing public debt. However, in order to achieve such sustainable policies, municipalities have widely cut investments in local infrastructure. From a long-term perspective, such development is problematic with respect to the quality of available infrastructure.

Computerized axiography in TMD patients before and after therapy with ‘function generating bites’

Abstract: The study evaluates the temporomandibular joint (TMJ) movements of patients with signs and symptoms of temporomandibular disorders (TMD) before and after therapy with the functional appliances of the 'function generating bite' (FGB) type. Thirty subjects suffering from TMD were selected and divided into two groups: group A (young patients: four males, nine females, mean age +/- standard deviation: 13.3+/-1.5 years); group B (adults: three males, 14 females, mean age +/- standard deviation: 23.2+/-4.4 years). A control group comprised 13 healthy subjects with perfect normal occlusion, TMD-free, was matched for age and sex with patient groups and was examined at T0 and after 12 months (T1). Computerized axiography was performed before and after therapy (average 13 months) with FGBs to evaluate any difference in condyle border movements. Results showed a statistically significant improvement after treatment, for groups A and B, in length, clicks, tracings with normal morphology, superimposition, deviations, regularity and return to starting position and speed (statistical analysis: chi-squared test) except for the symmetry of tracings which was significantly improved only for the young patient group. No statistically significant differences at time T0/T1 were found in the control group. In conclusion, the study shows that the TMJ tracings of TMD patients before and after therapy with 'FGB' significantly improve especially in young patients. FGB may be a useful appliance to improve TMJ function in young and adult TMD patients requiring orthodontic treatment.

Mental Health in Adolescents during COVID-19-Related Social Distancing and Home-Schooling

Abstract: This study assessed mental health in adolescents during the COVID-19 pandemic in Austria. An online survey (between February 3rd and 28th, 2021) was conducted measuring well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), as well as disordered eating (EAT-8) in 14 to 20 year-old adolescents. In total N=3052 individuals participated (70.1 % female) and showed clinically relevant 1) depressive symptoms (55%), anxiety symptoms (47%), insomnia (23%), and eating disorder symptoms (64%). The prevalence of repeated suicidal ideation was 16% (9% nearly every day; 7% on more than half of the days per week). Compared to a HBSC-study from 2018 an increase of smartphone usage, a decrease of physical activity, and a decrease of mental well-being (WHO-5) from 43.7 (SD = 19.84) in 2018 to M = 35.79 (SD = 19.67) in female participants (t(2136) = -18.58; p < 0.001; d = -0.40) and a decrease from 53.1 (SD = 19.50) in 2018 to M = 43.93 (SD = 22.36) in male participants (t(855) = -12.00; p < 0.001; d = -0.43) was observed. Results suggests a high prevalence of mental disorders one year after the COVID-19 outbreak in Austria and highlight the need to implement health promotion and prevention strategies.