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Model projects of a regional budget or a model project according to § 64b SGB V have been for more than 18 years. The structural, economic, and therapeutic long-term effects are described in this paper.
The model project in the Steinburg district (Schleswig-Holstein) describes the developments between 2002 (index year) and 2020 that have developed through the regional budget. The article describes the situation and its specific changes in the first german model region. There is no comparable control group.
In the observed period, the number of people treated was stable within a corridor that has been in the contract with the stakeholders. Care has shifted relevantly from fully inpatient to outpatient and day clinic treatment. The costs have remained stable and thus differ significantly from the overall increase in health care costs. New supply concepts could be implemented.
The model projects described lead to setting-independent care and are suitable for standard care in a defined region.
The model projects described lead to setting-independent care and are suitable for standard care in a defined region.
The implementation of Inpatient-equivalent treatment (IET) is advocated. In the Munich IET-program about 50 % of the IET patients were admitted directly whereas 50 % were transferred from inpatient units.
Data on the first N = 169 IET patients were used to compare patients being directly admitted with those who were transferred from inpatients units to IET.
Patients admitted directly to IET more often had an affective disorder, had lower CGI scores, had better German language skills and were more often competitively employed. Most patients referred to IET from inpatient units (66 %) did not fulfil IET inclusion criteria during inpatient admission. Regarding IET duration there were no major differences between patients being directly admitted vs. those being transferred from inpatient units.
Patients not fulfilling IET inclusion criteria may still profit from CHRT after stabilization on inpatient units.
Patients not fulfilling IET inclusion criteria may still profit from CHRT after stabilization on inpatient units.Investigation of cyberchondria is still in its infancy. Preliminary research suggests that cyberchondria is likely to represent a distinct behavioral syndrome which is closely associated with health anxiety/hypochondria and extensive online searching for health information and/or digital self-tracking. The internet is characterized by anonymous, readily, convenient space-time-independent accessibility and availability of an almost unmanageable amount of information that may increase the reassurance-seeking safety behavior of individuals with heightened health anxiety. Cyberchondria also appears to be related to low self-esteem, anxiety sensitivity, intolerance of uncertainty, compulsivity and metacognitive beliefs. At present, it is unclear of whether individuals with cyberchondria suffer from extensive health-related online searching behavior only or also from other forms of internet use disorders. The link between cyberchondria and e-health literacy, defined as perceived skills at finding, evaluating, and applying online health information to health problems, is poorly recognized. At present, there are no standardized therapeutic interventions for cyberchondria available. Treatment should address the maladaptive health- or illness-related assumptions and beliefs by using existing, well established approaches for hypochondria. Furthermore, it should target the problematic internet use and enable individuals with cyberchondria to reflect their subjective e-health literacy and promote a functional use of health resources from the internet.
The National Institute of Child Health and Human Development (NICHD) magnetic resonance imaging (MRI) pattern of brain injury is a known biomarker of childhood outcome following therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy (HIE). However, usefulness of this classification has not been evaluated to predict short-term outcomes. selleck chemicals llc The study aimed to test the hypothesis that infants with NICHD MRI pattern of severe hypoxic-ischemic brain injury will be sicker with more severe asphyxia-induced multiorgan dysfunction resulting in prolonged length of stay (LOS) following therapeutic hypothermia. We also evaluated the role of other risk factors which may prolong LOS.
We retrospectively reviewed the medical records of 71 consecutively cooled neonates to examine the ability of MRI patterns of brain injury to predict the LOS. A neuroradiologist masked to outcomes classified the patterns of brain injury on MRI as per NICHD. Pattern 2A (basal ganglia thalamic, internal capsule, or watershed infined by the NICHD.
· The NICHD pattern of brain injury on MRI predicts neurodevelopmental outcome following hypothermia treatment for neonatal HIE.. · LOS did not differ between the infants with and without MRI patterns of severe injury.. · The severity of brain injury as defined by the NICHD was not predictive of the LOS following therapeutic hypothermia..
· The NICHD pattern of brain injury on MRI predicts neurodevelopmental outcome following hypothermia treatment for neonatal HIE.. · LOS did not differ between the infants with and without MRI patterns of severe injury.. · The severity of brain injury as defined by the NICHD was not predictive of the LOS following therapeutic hypothermia..The role of lutetium-177 among bone-seeking radionuclides in targeted therapy is noteworthy. The clinical pharmacokinetics of ibandronate (IBA) indicates that this bisphonate has powerful bone mineral affinity. The aim of this study was to evaluate of [177Lu]Lu-IBA efficacy as a new compound.The [177Lu]Lu-IBA was prepared by radiolabeling of IBA ligand to 177LuCl3 that was obtained by thermal neutron irradiation of enriched Lu2O3 sample. Produced [177Lu]Lu-IBA with high radiochemical purity was administered intravenously to mice. Biodistribution data were collected at 1, 4, 24, 48 h and 7 d post injections. With calculating accumulated activities in each organ and extrapolating mouse's organs to human's organs by the RADAR method and using OLINDA/EXM software the injected dose in various human organs was achieved.[177Lu]Lu-IBA was produced with radiochemical purity nearly 96 %. Its biodistribution data showed the high uptake and durability in the skeletal tissues without significant uptake in other major organs.
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