BackgroundPatient centeredness is an integral part of the quality of care. Patient-reported exper... more BackgroundPatient centeredness is an integral part of the quality of care. Patient-reported experience measures (PREMs) are assumed to be an appropriate tool to assess patient-centredness. An evaluation of German-speaking PREMs is lacking.ObjectiveTo perform a systematic review and qualitative analysis of psychometric measurement qualities of German-speaking PREMs.MethodsA systematic literature search was performed in Medline, PsycInfo, CINHAL, Embase, Cochrane database (last search 9th November 2021) for studies describing generic, surgery-or cancer-specific PREMs. Subsequently, questionnaires that were not in German or for which no German translation exists were excluded. Furthermore, questionnaires, that are for healthcare professionals rather than patients as well as disease-specific questionnaires were excluded. Baseline data for all studies was extracted by two independent reviewers. Psychometric measurement qualities of the questionnaires were assessed according to the COSMIN...
The current paper presents the 2 nd replication of a hypothetic model that-based on theoretical r... more The current paper presents the 2 nd replication of a hypothetic model that-based on theoretical reasoning as well as on empirical results-has been developed in order to predict useful sizes of HR departments and explain differences in the HR-staff-ratio in different organisations of different countries. Empirical tests using the survey data from Cranet-G from the survey rounds 1999, 2004/5 and 2008/09 confirm that the theoretical model, first developed in 2001, is still valid. The new version of the model integrates country specific influences.
Significant expression of neprilysin (NEP) is found on neutrophils, which present the transmembra... more Significant expression of neprilysin (NEP) is found on neutrophils, which present the transmembrane integer form of the enzyme. This study aimed to investigate the relationship of neutrophil transmembrane neprilysin (mNEP) with disease severity, adverse remodeling, and outcome in HFrEF. In total, 228 HFrEF, 30 HFpEF patients, and 43 controls were enrolled. Neutrophil mNEP was measured by flow-cytometry. NEP activity in plasma and blood cells was determined for a subset of HFrEF patients using mass-spectrometry. Heart failure (HF) was characterized by reduced neutrophil mNEP compared to controls (p < 0.01). NEP activity on peripheral blood cells was almost 4-fold higher compared to plasma NEP activity (p = 0.031) and correlated with neutrophil mNEP (p = 0.006). Lower neutrophil mNEP was associated with increasing disease severity and markers of adverse remodeling. Higher neutrophil mNEP was associated with reduced risk for mortality, total cardiovascular hospitalizations, and the ...
Whereas sudden gains and losses (large shifts in symptom severity) in patients receiving psychoth... more Whereas sudden gains and losses (large shifts in symptom severity) in patients receiving psychotherapy appear abrupt and hence may seem unexpected, hypotheses from complex-systems theory suggest that sudden gains and losses are actually preceded by certain early-warning signals (EWSs). We tested whether EWSs in patients’ daily self-ratings of the psychotherapeutic process predicted future sudden gains and losses. Data were collected from 328 patients receiving psychotherapy for mood disorders who completed daily self-ratings about their therapeutic process using the Therapy Process Questionnaire (TPQ). Sudden gains and losses were classified from the Problem Intensity scale of the TPQ. The other items of the TPQ were used to compute the EWSs. EWSs predicted an increased probability for sudden gains and losses in a 4-day predictive window. These results show that EWSs can be used for real-time prediction of sudden gains and losses in clinical practice.
In Japan, the multicenter prospective study (SAVE-J) is in process to examine extracorporeal card... more In Japan, the multicenter prospective study (SAVE-J) is in process to examine extracorporeal cardiopulmonary resuscitation (ECPR) and conventional advanced life support (ALS) for patient in out-of hospital cardiac arrest (OHCA) with ventricular fibrillation, or pulseless ventricular tachycardia as initial rhythm. As from the SAVE-J study's interim report of last year's conference, efficacy for OHCA has been shown. But on the other hand, ECPR is costly treatment and to gain recognition, the cost effectiveness analysis is necessary. Materials and Methods: The costs and outcomes of the registered cases of SAVE-J from October 2008 to December 2009 were evaluated. The main outcome measures were quality-adjusted survival after cardiac arrest, cost of ECPR implementation, cost of post-hospital discharge care, and incremental cost-effectiveness ratios (ICER). The costs were worked up according to Japanese healthcare service. Results: There were 105 cases of percutaneous cardiopulmonary support (PCPS) group (underwent ECPR), and 68 cases of non-PCPS group, of which met criteria of SAVE-J and outcomes were reported. In PCPS group, there were 20 cases of favorable outcome (CPC 1-2), 20 cases of poor outcome (CPC 3-4), and 65 cases of death (CPC 5) at 1 month. In non-PCPS group, there were 1 case of favorable outcome, 7 cases of poor outcome and 62 death cases. The costs per Quality Adjusted Life Years (QALY) were 6,104,260 yen in PCPS group, and 18,696,480 yen in non-PCPS group. The ICER was 5,004,680 yen per QALY. Discussion: In Japan, the criteria of introducing new treatment are about 5,000,000 yen per QALY or less. The cost effectiveness of ECPR was at upper limit in this analysis and it is worthwhile to continue the assessment. Conclusion: ECPR has chance of gaining recognition for cost effective treatment.
Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, foll... more Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, followed by biennial refresher courses. Currently, both standardized ERC advanced life support (ALS) provider courses and conventional refresher courses are offered. This study aimed to compare the retention of ALS-knowledge of out-of-hospital emergency physicians depending on whether they had or had not participated in an ERC-ALS provider course since 2005. Participants (n=807) from 19 refresher courses for out-of-hospital emergency physicians answered eight multiple-choice questions (MCQ) about ALS based on the 2005 ERC guidelines. The pass score was 75% correct answers. A multivariate logistic regression analyzed differences in passing scores between those who had previously participated in an ERC-ALS provider course and those who had not. Age, gender, regularity of working as an out-of-hospital emergency physician and the self-reported number of real resuscitation efforts within the last...
The conventional view on interventions as mechanistically causing interchangeable clients to get ... more The conventional view on interventions as mechanistically causing interchangeable clients to get better has come under attack. Group-based and linear approaches fall short in adequately describing the idiosyncratic and dynamic nature of treatment processes. Non-linear dynamic system theories in contrast hold great potential to better conceptualize and understand the generalities and idiosyncrasies of psychotherapeutic change processes. The aim of this study was to examine whether we can detect markers of complex dynamical systems behavior in two single-case therapies. All sessions from both therapies were coded with sequential plan analysis using a 10s sampling frequency. The coding system incorporates verbal and non-verbal behaviors and allows for the representation of contextualized interactive behaviors. The high sampling frequency results in long time series, which allowed us to apply non-linear analysis techniques. We found strong support for complex behavior and the existence of a butterfly effect, i.e., a relatively short prediction horizon in which reliable predictions about the system's future behavior could be made. Further, critical fluctuations as a marker for phase-transitions were detected that were accompanied with different interactional patterns in both therapies. Finally, there was strong support for self-organized pattern formation, with a few interactional patterns dominating the interaction. Considering that we are intervening on complex dynamical systems means that we have to (1) acknowledge the principal individuality of change processes, (2) accept the fundamental limitations of the mechanistic input-output model of treatment effects and (3) appreciate the impossibility of long-term predictions of treatment responses.
Journal of the American College of Cardiology, 2013
The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk dia... more The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk diabetic patients selected by N-terminal pro-B-type natriuretic peptide (NT-proBNP). Background Few clinical trials have successfully demonstrated the prevention of cardiac events in patients with diabetes. One reason for this might be an inaccurate selection of patients. NT-proBNP has not been assessed in this context. Methods A total of 300 patients with type 2 diabetes, elevated NT-proBNP (>125 pg/ml) but free of cardiac disease were randomized. The "control" group was cared for at 4 diabetes care units; the "intensified" group was additionally treated at a cardiac outpatient clinic for the up-titration of renin-angiotensin system (RAS) antagonists and betablockers. The primary endpoint was hospitalization/death due to cardiac disease after 2 years. Results At baseline, the mean age of the patients was 67.5 AE 9 years, duration of diabetes was 15 AE 12 years, 37% were male, HbA 1c was 7 AE 1.1%, blood pressure was 151 AE 22 mm Hg, heart rate was 72 AE 11 beats/min, median NT-proBNP was 265.5 pg/ml (interquartile range: 180.8 to 401.8 pg/ml). After 12 months there was a significant difference between the number of patients treated with a RAS antagonist/beta-blocker and the dosage reached between groups (p < 0.0001). Blood pressure was significantly reduced in both (p < 0.05); heart rate was only reduced in the intensified group (p ¼ 0.004). A significant reduction of the primary endpoint (hazard ratio: 0.351; 95% confidence interval: 0.127 to 0.975, p ¼ 0.044) was visible in the intensified group. The same was true for other endpoints: all-cause hospitalization, unplanned cardiovascular hospitalizations/death (p < 0.05 for all). Conclusions Accelerated up-titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP. (Nt-proBNP Guided Primary Prevention of CV Events in Diabetic Patients [PONTIAC]; NCT00562952) (J Am Coll Cardiol 2013;62:1365-72) ª 2013 by the American College of Cardiology Foundation Diabetes mellitus is considered one of the primary causes of cardiac disease. It is, therefore, remarkable that to date there have been no clinical trials conducted with diabetic patients focusing on the primary prevention of cardiac disease. Furthermore, most trials have failed to demonstrate a secondary preventive effect of treatment in patients with diabetes (1-4). Only 2 studies showed a reduction of cardiovascular events (5,6), and in some studies events even increased under therapy (7,8). Surprisingly, during the ambitious recent trials cardiac events were less frequent than anticipated, even in pre-selected risk populations (1,7-9). The inclusion and exclusion criteria applied in these studies have been highlighted as one reason From the
Operationalizing Career Complexity ** There are a growing number of studies describing developmen... more Operationalizing Career Complexity ** There are a growing number of studies describing developments in the labour market, in employer-employee relationships, and in individual careers in a very similar way. The discussion about work force flexibility and the challenges for HRM to handle scattered arrangements is often justified by a growing complexity caused by the driving forces of globalization, virtualization, demographic developments or changes in values. However, so far there is no empirical evidence for that complexity hypothesis in individual careers. The primary aim of this article is to approach the complexity hypothesis of career research on the basis of a sound definition for complexity and to test the complexity hypothesis for data from the Vienna Career Panel Project.
Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch ge... more Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may be saved and copied for your personal and scholarly purposes. You are not to copy documents for public or commercial purposes, to exhibit the documents publicly, to make them publicly available on the internet, or to distribute or otherwise use the documents in public. If the documents have been made available under an Open Content Licence (especially Creative Commons Licences), you may exercise further usage rights as specified in the indicated licence.
European heart journal cardiovascular Imaging, Jun 9, 2018
Secondary mitral regurgitation (MR) drives adverse remodelling towards late heart failure stages.... more Secondary mitral regurgitation (MR) drives adverse remodelling towards late heart failure stages. Little is known about the evolution of MR under guideline-directed therapy (GDT) and its relation to cardiac remodelling and outcome. We therefore aimed to assess incidence, impact, and predictors of progressive secondary MR in patients under GDT. We prospectively enrolled 249 patients with chronic heart failure and reduced ejection fraction receiving GDT in this long-term observational study. Of patients with non-severe MR at baseline 81% remained stable whereas 19% had progressive MR. Those patients were more symptomatic (P < 0.001), had higher neurohumoral activation (encompassing various neurohumoral pathways in heart failure, all P < 0.05), larger left atrial size (P = 0.004) and more tricuspid regurgitation (TR, P = 0.02). During a median follow-up of 61 months (IQR 50-72), 61 patients died. Progression of MR conveyed an increased risk of mortality-univariately (HR 2.33; 95%...
German Journal of Human Resource Management: Zeitschrift für Personalforschung
In der Diskussion um die berufliche Gleichstellung der Geschlechter spielt die bedingte Chancengl... more In der Diskussion um die berufliche Gleichstellung der Geschlechter spielt die bedingte Chancengleichheit eine wichtige Rolle. Bei gleichen Ausgangsbedingungen sollten Frauen wie Männern die gleichen Karrieremöglichkeiten offen stehen. Die Analyse der Karrieren von 43 Absolventinnen und 51 Absolventen wirtschaftswissenschaftlicher Studiengänge der Wirtschaftsuniversität Wien zeigt dramatische Gehaltsunterschiede, obwohl die beiden Gruppen sich in Hinblick auf 26 karriererelevante Variablen nicht unterscheiden. Als potentiell erklärende Variablen wurden zudem Karenzzeiten, geleistete Wochenarbeitszeit im Karriereverlauf und die Organisationsgröße zum Berufseinstieg herangezogen. Auch diese Größen können den gender pay gap nicht erklären.
Routinely tested liver biomarkers as alanine aminotransferase (ALT), aspartate aminotransferase (... more Routinely tested liver biomarkers as alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), butyryl-cholinesterase (BChE), albumin and bilirubin are altered in distinct malignancies and hepatic metastases. This study aimed to investigate whether all liver parameters have the ability to predict long-term mortality in treatment naïve cancer patients but without a malignant hepatic involvement. We prospectively enrolled 555 consecutive patients with primary diagnosis of cancer without prior anticancer therapy. BChE, albumin, AST, ALT, GGT and bilirubin as well as the inflammatory makers C-reactive protein (CRP), serum amyloid A (SAA) and interleukin-6 (IL-6) were determined. All-cause mortality was defined as primary endpoint. During a median follow-up of 25 (IQR16-31) months 186 (34%) patients died. All liver parameters were significantly associated with all-cause mortality (p < 0.001 for all). However, for patients without a malignant primar...
Diabetes has been linked epidemiologically to increased cancer incidence and mortality. Growth di... more Diabetes has been linked epidemiologically to increased cancer incidence and mortality. Growth differentiation factor 15 (GDF-15) is increased in patients with diabetes and has recently been linked to the occurrence of cancer. We investigated whether circulating GDF-15 concentrations can predict the incidence of malignant diseases in a diabetic patient cohort already facing increased risk for cancer. We prospectively enrolled a total of 919 patients with type 2 diabetes and no history of malignant disease, who were clinically followed up for 60 months. GDF-15, N-terminal pro-B-type natriuretic peptide and troponin T were measured at baseline; an additional 4 cardiovascular biomarkers were determined for a subpopulation (n = 259). Study end point was defined as the first diagnosis of any type of cancer during the follow-up period. During a median follow-up of 60 months, 66 patients (7.2%) were diagnosed with cancer. Baseline circulating GDF-15 concentrations were higher in patients t...
Http Dx Doi Org 10 1080 17448680903351818, Nov 24, 2009
ABSTRACT Given that the quality and solidity of civil society depend on the amount of civic engag... more ABSTRACT Given that the quality and solidity of civil society depend on the amount of civic engagement, the question why some groups engage while others do not becomes a major issue for research. This paper aims to identify factors that might explain whether or not citizens participate in civil society. In terms of theory, we refer to both Bourdieu&#39;s concept of ‘capitals’ as resources for civic participation and Putnam&#39;s viewpoint, which argues that civic participation is particularly motivated by trust, norms and networks. In the empirical part of the paper, we use data from the European Social Survey for Austria to identify potential factors that might explain civic participation. Based on regression and CHAID analyses, two indicators appear to be particularly important in explaining differences in the civic participation of individuals, i.e. citizenship values and social networks and activities. These variables are the strongest predictors regarding all types of participation analysed (donating money, volunteering and entering a membership association).
Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie, 2012
This contribution looks at the factorial structure of the Therapy Process Questionnaire (TPQ), wh... more This contribution looks at the factorial structure of the Therapy Process Questionnaire (TPQ), which is used for daily self-ratings of patients tested by internet-based ambulatory assessment devices. A combined explorative and confirmatory factor analysis of the TPQ. The time-series data were generated by 149 patients treated in an inpatient setting. 23 out of 42 items included in the explorative version of the TPQ are represented onto five factors, which were identified by a first explorative factor analysis and then validated by a confirmative factor analysis. We report on the psychometric data of the subscales: internal consistency (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s α), mean of item-intercorrelation, and mean of item discrimination indices. The TPQ is useful for a high-frequency and equidistant (daily) assessment of psychotherapeutic change processes.
BackgroundPatient centeredness is an integral part of the quality of care. Patient-reported exper... more BackgroundPatient centeredness is an integral part of the quality of care. Patient-reported experience measures (PREMs) are assumed to be an appropriate tool to assess patient-centredness. An evaluation of German-speaking PREMs is lacking.ObjectiveTo perform a systematic review and qualitative analysis of psychometric measurement qualities of German-speaking PREMs.MethodsA systematic literature search was performed in Medline, PsycInfo, CINHAL, Embase, Cochrane database (last search 9th November 2021) for studies describing generic, surgery-or cancer-specific PREMs. Subsequently, questionnaires that were not in German or for which no German translation exists were excluded. Furthermore, questionnaires, that are for healthcare professionals rather than patients as well as disease-specific questionnaires were excluded. Baseline data for all studies was extracted by two independent reviewers. Psychometric measurement qualities of the questionnaires were assessed according to the COSMIN...
The current paper presents the 2 nd replication of a hypothetic model that-based on theoretical r... more The current paper presents the 2 nd replication of a hypothetic model that-based on theoretical reasoning as well as on empirical results-has been developed in order to predict useful sizes of HR departments and explain differences in the HR-staff-ratio in different organisations of different countries. Empirical tests using the survey data from Cranet-G from the survey rounds 1999, 2004/5 and 2008/09 confirm that the theoretical model, first developed in 2001, is still valid. The new version of the model integrates country specific influences.
Significant expression of neprilysin (NEP) is found on neutrophils, which present the transmembra... more Significant expression of neprilysin (NEP) is found on neutrophils, which present the transmembrane integer form of the enzyme. This study aimed to investigate the relationship of neutrophil transmembrane neprilysin (mNEP) with disease severity, adverse remodeling, and outcome in HFrEF. In total, 228 HFrEF, 30 HFpEF patients, and 43 controls were enrolled. Neutrophil mNEP was measured by flow-cytometry. NEP activity in plasma and blood cells was determined for a subset of HFrEF patients using mass-spectrometry. Heart failure (HF) was characterized by reduced neutrophil mNEP compared to controls (p < 0.01). NEP activity on peripheral blood cells was almost 4-fold higher compared to plasma NEP activity (p = 0.031) and correlated with neutrophil mNEP (p = 0.006). Lower neutrophil mNEP was associated with increasing disease severity and markers of adverse remodeling. Higher neutrophil mNEP was associated with reduced risk for mortality, total cardiovascular hospitalizations, and the ...
Whereas sudden gains and losses (large shifts in symptom severity) in patients receiving psychoth... more Whereas sudden gains and losses (large shifts in symptom severity) in patients receiving psychotherapy appear abrupt and hence may seem unexpected, hypotheses from complex-systems theory suggest that sudden gains and losses are actually preceded by certain early-warning signals (EWSs). We tested whether EWSs in patients’ daily self-ratings of the psychotherapeutic process predicted future sudden gains and losses. Data were collected from 328 patients receiving psychotherapy for mood disorders who completed daily self-ratings about their therapeutic process using the Therapy Process Questionnaire (TPQ). Sudden gains and losses were classified from the Problem Intensity scale of the TPQ. The other items of the TPQ were used to compute the EWSs. EWSs predicted an increased probability for sudden gains and losses in a 4-day predictive window. These results show that EWSs can be used for real-time prediction of sudden gains and losses in clinical practice.
In Japan, the multicenter prospective study (SAVE-J) is in process to examine extracorporeal card... more In Japan, the multicenter prospective study (SAVE-J) is in process to examine extracorporeal cardiopulmonary resuscitation (ECPR) and conventional advanced life support (ALS) for patient in out-of hospital cardiac arrest (OHCA) with ventricular fibrillation, or pulseless ventricular tachycardia as initial rhythm. As from the SAVE-J study's interim report of last year's conference, efficacy for OHCA has been shown. But on the other hand, ECPR is costly treatment and to gain recognition, the cost effectiveness analysis is necessary. Materials and Methods: The costs and outcomes of the registered cases of SAVE-J from October 2008 to December 2009 were evaluated. The main outcome measures were quality-adjusted survival after cardiac arrest, cost of ECPR implementation, cost of post-hospital discharge care, and incremental cost-effectiveness ratios (ICER). The costs were worked up according to Japanese healthcare service. Results: There were 105 cases of percutaneous cardiopulmonary support (PCPS) group (underwent ECPR), and 68 cases of non-PCPS group, of which met criteria of SAVE-J and outcomes were reported. In PCPS group, there were 20 cases of favorable outcome (CPC 1-2), 20 cases of poor outcome (CPC 3-4), and 65 cases of death (CPC 5) at 1 month. In non-PCPS group, there were 1 case of favorable outcome, 7 cases of poor outcome and 62 death cases. The costs per Quality Adjusted Life Years (QALY) were 6,104,260 yen in PCPS group, and 18,696,480 yen in non-PCPS group. The ICER was 5,004,680 yen per QALY. Discussion: In Japan, the criteria of introducing new treatment are about 5,000,000 yen per QALY or less. The cost effectiveness of ECPR was at upper limit in this analysis and it is worthwhile to continue the assessment. Conclusion: ECPR has chance of gaining recognition for cost effective treatment.
Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, foll... more Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, followed by biennial refresher courses. Currently, both standardized ERC advanced life support (ALS) provider courses and conventional refresher courses are offered. This study aimed to compare the retention of ALS-knowledge of out-of-hospital emergency physicians depending on whether they had or had not participated in an ERC-ALS provider course since 2005. Participants (n=807) from 19 refresher courses for out-of-hospital emergency physicians answered eight multiple-choice questions (MCQ) about ALS based on the 2005 ERC guidelines. The pass score was 75% correct answers. A multivariate logistic regression analyzed differences in passing scores between those who had previously participated in an ERC-ALS provider course and those who had not. Age, gender, regularity of working as an out-of-hospital emergency physician and the self-reported number of real resuscitation efforts within the last...
The conventional view on interventions as mechanistically causing interchangeable clients to get ... more The conventional view on interventions as mechanistically causing interchangeable clients to get better has come under attack. Group-based and linear approaches fall short in adequately describing the idiosyncratic and dynamic nature of treatment processes. Non-linear dynamic system theories in contrast hold great potential to better conceptualize and understand the generalities and idiosyncrasies of psychotherapeutic change processes. The aim of this study was to examine whether we can detect markers of complex dynamical systems behavior in two single-case therapies. All sessions from both therapies were coded with sequential plan analysis using a 10s sampling frequency. The coding system incorporates verbal and non-verbal behaviors and allows for the representation of contextualized interactive behaviors. The high sampling frequency results in long time series, which allowed us to apply non-linear analysis techniques. We found strong support for complex behavior and the existence of a butterfly effect, i.e., a relatively short prediction horizon in which reliable predictions about the system's future behavior could be made. Further, critical fluctuations as a marker for phase-transitions were detected that were accompanied with different interactional patterns in both therapies. Finally, there was strong support for self-organized pattern formation, with a few interactional patterns dominating the interaction. Considering that we are intervening on complex dynamical systems means that we have to (1) acknowledge the principal individuality of change processes, (2) accept the fundamental limitations of the mechanistic input-output model of treatment effects and (3) appreciate the impossibility of long-term predictions of treatment responses.
Journal of the American College of Cardiology, 2013
The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk dia... more The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk diabetic patients selected by N-terminal pro-B-type natriuretic peptide (NT-proBNP). Background Few clinical trials have successfully demonstrated the prevention of cardiac events in patients with diabetes. One reason for this might be an inaccurate selection of patients. NT-proBNP has not been assessed in this context. Methods A total of 300 patients with type 2 diabetes, elevated NT-proBNP (>125 pg/ml) but free of cardiac disease were randomized. The "control" group was cared for at 4 diabetes care units; the "intensified" group was additionally treated at a cardiac outpatient clinic for the up-titration of renin-angiotensin system (RAS) antagonists and betablockers. The primary endpoint was hospitalization/death due to cardiac disease after 2 years. Results At baseline, the mean age of the patients was 67.5 AE 9 years, duration of diabetes was 15 AE 12 years, 37% were male, HbA 1c was 7 AE 1.1%, blood pressure was 151 AE 22 mm Hg, heart rate was 72 AE 11 beats/min, median NT-proBNP was 265.5 pg/ml (interquartile range: 180.8 to 401.8 pg/ml). After 12 months there was a significant difference between the number of patients treated with a RAS antagonist/beta-blocker and the dosage reached between groups (p < 0.0001). Blood pressure was significantly reduced in both (p < 0.05); heart rate was only reduced in the intensified group (p ¼ 0.004). A significant reduction of the primary endpoint (hazard ratio: 0.351; 95% confidence interval: 0.127 to 0.975, p ¼ 0.044) was visible in the intensified group. The same was true for other endpoints: all-cause hospitalization, unplanned cardiovascular hospitalizations/death (p < 0.05 for all). Conclusions Accelerated up-titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP. (Nt-proBNP Guided Primary Prevention of CV Events in Diabetic Patients [PONTIAC]; NCT00562952) (J Am Coll Cardiol 2013;62:1365-72) ª 2013 by the American College of Cardiology Foundation Diabetes mellitus is considered one of the primary causes of cardiac disease. It is, therefore, remarkable that to date there have been no clinical trials conducted with diabetic patients focusing on the primary prevention of cardiac disease. Furthermore, most trials have failed to demonstrate a secondary preventive effect of treatment in patients with diabetes (1-4). Only 2 studies showed a reduction of cardiovascular events (5,6), and in some studies events even increased under therapy (7,8). Surprisingly, during the ambitious recent trials cardiac events were less frequent than anticipated, even in pre-selected risk populations (1,7-9). The inclusion and exclusion criteria applied in these studies have been highlighted as one reason From the
Operationalizing Career Complexity ** There are a growing number of studies describing developmen... more Operationalizing Career Complexity ** There are a growing number of studies describing developments in the labour market, in employer-employee relationships, and in individual careers in a very similar way. The discussion about work force flexibility and the challenges for HRM to handle scattered arrangements is often justified by a growing complexity caused by the driving forces of globalization, virtualization, demographic developments or changes in values. However, so far there is no empirical evidence for that complexity hypothesis in individual careers. The primary aim of this article is to approach the complexity hypothesis of career research on the basis of a sound definition for complexity and to test the complexity hypothesis for data from the Vienna Career Panel Project.
Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch ge... more Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may be saved and copied for your personal and scholarly purposes. You are not to copy documents for public or commercial purposes, to exhibit the documents publicly, to make them publicly available on the internet, or to distribute or otherwise use the documents in public. If the documents have been made available under an Open Content Licence (especially Creative Commons Licences), you may exercise further usage rights as specified in the indicated licence.
European heart journal cardiovascular Imaging, Jun 9, 2018
Secondary mitral regurgitation (MR) drives adverse remodelling towards late heart failure stages.... more Secondary mitral regurgitation (MR) drives adverse remodelling towards late heart failure stages. Little is known about the evolution of MR under guideline-directed therapy (GDT) and its relation to cardiac remodelling and outcome. We therefore aimed to assess incidence, impact, and predictors of progressive secondary MR in patients under GDT. We prospectively enrolled 249 patients with chronic heart failure and reduced ejection fraction receiving GDT in this long-term observational study. Of patients with non-severe MR at baseline 81% remained stable whereas 19% had progressive MR. Those patients were more symptomatic (P < 0.001), had higher neurohumoral activation (encompassing various neurohumoral pathways in heart failure, all P < 0.05), larger left atrial size (P = 0.004) and more tricuspid regurgitation (TR, P = 0.02). During a median follow-up of 61 months (IQR 50-72), 61 patients died. Progression of MR conveyed an increased risk of mortality-univariately (HR 2.33; 95%...
German Journal of Human Resource Management: Zeitschrift für Personalforschung
In der Diskussion um die berufliche Gleichstellung der Geschlechter spielt die bedingte Chancengl... more In der Diskussion um die berufliche Gleichstellung der Geschlechter spielt die bedingte Chancengleichheit eine wichtige Rolle. Bei gleichen Ausgangsbedingungen sollten Frauen wie Männern die gleichen Karrieremöglichkeiten offen stehen. Die Analyse der Karrieren von 43 Absolventinnen und 51 Absolventen wirtschaftswissenschaftlicher Studiengänge der Wirtschaftsuniversität Wien zeigt dramatische Gehaltsunterschiede, obwohl die beiden Gruppen sich in Hinblick auf 26 karriererelevante Variablen nicht unterscheiden. Als potentiell erklärende Variablen wurden zudem Karenzzeiten, geleistete Wochenarbeitszeit im Karriereverlauf und die Organisationsgröße zum Berufseinstieg herangezogen. Auch diese Größen können den gender pay gap nicht erklären.
Routinely tested liver biomarkers as alanine aminotransferase (ALT), aspartate aminotransferase (... more Routinely tested liver biomarkers as alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), butyryl-cholinesterase (BChE), albumin and bilirubin are altered in distinct malignancies and hepatic metastases. This study aimed to investigate whether all liver parameters have the ability to predict long-term mortality in treatment naïve cancer patients but without a malignant hepatic involvement. We prospectively enrolled 555 consecutive patients with primary diagnosis of cancer without prior anticancer therapy. BChE, albumin, AST, ALT, GGT and bilirubin as well as the inflammatory makers C-reactive protein (CRP), serum amyloid A (SAA) and interleukin-6 (IL-6) were determined. All-cause mortality was defined as primary endpoint. During a median follow-up of 25 (IQR16-31) months 186 (34%) patients died. All liver parameters were significantly associated with all-cause mortality (p < 0.001 for all). However, for patients without a malignant primar...
Diabetes has been linked epidemiologically to increased cancer incidence and mortality. Growth di... more Diabetes has been linked epidemiologically to increased cancer incidence and mortality. Growth differentiation factor 15 (GDF-15) is increased in patients with diabetes and has recently been linked to the occurrence of cancer. We investigated whether circulating GDF-15 concentrations can predict the incidence of malignant diseases in a diabetic patient cohort already facing increased risk for cancer. We prospectively enrolled a total of 919 patients with type 2 diabetes and no history of malignant disease, who were clinically followed up for 60 months. GDF-15, N-terminal pro-B-type natriuretic peptide and troponin T were measured at baseline; an additional 4 cardiovascular biomarkers were determined for a subpopulation (n = 259). Study end point was defined as the first diagnosis of any type of cancer during the follow-up period. During a median follow-up of 60 months, 66 patients (7.2%) were diagnosed with cancer. Baseline circulating GDF-15 concentrations were higher in patients t...
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ABSTRACT Given that the quality and solidity of civil society depend on the amount of civic engag... more ABSTRACT Given that the quality and solidity of civil society depend on the amount of civic engagement, the question why some groups engage while others do not becomes a major issue for research. This paper aims to identify factors that might explain whether or not citizens participate in civil society. In terms of theory, we refer to both Bourdieu&#39;s concept of ‘capitals’ as resources for civic participation and Putnam&#39;s viewpoint, which argues that civic participation is particularly motivated by trust, norms and networks. In the empirical part of the paper, we use data from the European Social Survey for Austria to identify potential factors that might explain civic participation. Based on regression and CHAID analyses, two indicators appear to be particularly important in explaining differences in the civic participation of individuals, i.e. citizenship values and social networks and activities. These variables are the strongest predictors regarding all types of participation analysed (donating money, volunteering and entering a membership association).
Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie, 2012
This contribution looks at the factorial structure of the Therapy Process Questionnaire (TPQ), wh... more This contribution looks at the factorial structure of the Therapy Process Questionnaire (TPQ), which is used for daily self-ratings of patients tested by internet-based ambulatory assessment devices. A combined explorative and confirmatory factor analysis of the TPQ. The time-series data were generated by 149 patients treated in an inpatient setting. 23 out of 42 items included in the explorative version of the TPQ are represented onto five factors, which were identified by a first explorative factor analysis and then validated by a confirmative factor analysis. We report on the psychometric data of the subscales: internal consistency (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s α), mean of item-intercorrelation, and mean of item discrimination indices. The TPQ is useful for a high-frequency and equidistant (daily) assessment of psychotherapeutic change processes.
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Papers by Guido Strunk