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Forschungsbericht 2013
(2014)
Forschungsbericht 2015
(2016)
Background: Joint contractures are a common health problem in older persons with significant impact on activities of daily living. We aimed to retrieve outcome measures applied in studies on older persons with joint contractures and to identify and categorise the concepts contained in these outcome measures using the ICF (International Classification of Functioning, Disability and Health) as a reference.
Methods: Electronic searches of Medline, EMBASE, CINAHL, Pedro and the Cochrane Library were conducted (1/2002-8/2012). We included studies in the geriatric rehabilitation and nursing home settings with participants aged ≥ 65 years and with acquired joint contractures. Two independent reviewers extracted the outcome measures and transferred them to concepts using predefined conceptual frameworks. Concepts were subsequently linked to the ICF categories.
Results: From the 1057 abstracts retrieved, 60 studies met the inclusion criteria. We identified 52 single outcome measures and 24 standardised assessment instruments. A total of 1353 concepts were revealed from the outcome measures; 96.2 % could be linked to 50 ICF categories in the 2nd level; 3.8 % were not categorised. Fourteen of the 50 categories (28 %) belonged to the component Body Functions, 4 (8 %) to the component Body Structures, 26 (52 %) to the component Activities and Participation, and 6 (12 %) to the component Environmental Factors.
Conclusions: The ICF is a valuable reference for identifying and quantifying the concepts of outcome measures on joint contractures in older people. The revealed ICF categories remain to be validated in populations with joint contractures in terms of clinical relevance and personal impact.
Forschungsbericht 2014
(2015)
Purpose
The purpose of this paper is to investigate how professional football clubs from the English Premier League, German Bundesliga and Spanish Primera División use digital media to expand their international reach in emerging football markets (EFM) outside of Europe. Based on the EPRG framework and Rugman’s home-region hypothesis, the aim is to broaden the perspective where “sports go global” for a further understanding of actors’ international orientation in the digital sphere.
Design/methodology/approach
The study is based on data from desk research and a qualitative survey, comprising information on international digital media activities of 58 European clubs. Cluster analysis is used to identify different international orientations with regard to digital media activities.
Findings
The data provide evidence that clubs differ strongly in their orientations towards EFM. While some global players that provide digital media content in several EFM languages and attract a large share of Facebook followers from EFM exist, other clubs focus on their home region. League-specific differences become apparent.
Originality/value
This study determines the international online orientations of European football clubs by combining two previously separated research streams in football management studies: internationalisation and digital media activities. Most clubs with a strong EFM fan base choose polycentric, multi-language digital media strategies, followed by geocentric, standardised approaches. By offering a novel angle on internationalisation in professional football, this study contributes towards optimising clubs’ international online strategies for EFM, which are markets that promise high growth rates.
The IT architecture for meter reading and utility services is at the core of new business models and has a decisive role as an enabler for resource efficiency measures. The communication architecture used by those services has significant impact on cost, flexibility and speed of new service rollout. This article describes how the dominant system model for meter reading came about, what alternative models exist, and what trade-offs those models have for rollout of new services by different stakeholders. Control of a self learning home automation system by dynamic tariff information (Real-Time-Pricing) is given as an application example.
Introduction
Universal varicella vaccination of infants in Germany was shown to be effective and cost-saving by the EVITA-model (Economic Varicella VaccInation Tool for Analysis).[1] However, affordability proves to be a “fourth hurdle”. The objective of this study is to examine budget impacts of universal varicella vaccination from a payer’s (sickness funds’) perspective.
Methods
The validated, dynamic infections disease model EVITA was used to analyse budget impacts over 30 years. Universal vaccination of children in their second life year was compared to the currently recommended risk-group strategy. In the USA, universal varicella vaccination was implemented in 1996. Based on US-experience, three scenarios for the development of the coverage rates have been estimated. The price level of 2002 was used. Future costs were not discounted to show the full budget impact in future years. Aspects concerning the incidence of herpes zoster have not been included in the analysis.
Results
Under the current risk-group strategy, an annual average of 721,400 cases, 38,700 complications and 5,500 hospitalisations occur in Germany. Annual varicella costs for sickness funds amount to 73 million €, 50 % thereof due to sick-leave costs of parents staying at home to care for their sick child covered by sickness funds. Other costs relate to hospitalisations (24 %), physician services (12 %), medication (11 %) and vaccination (3 %). With a universal vaccination strategy, morbidity is on average reduced by 75 % to 80 % (this and the following results depend on the analysed scenario). Vaccination costs rise to a maximum of 42–43 million € p. a. within about 10–12 years and therefore account — at maximum — for about 0.03 % of the total payers’ health care budget. Other varicella costs however decrease by more than 80 % in the same time. Overall varicella costs rise by 8 % to 13 % in the first few years because of the additional investment in vaccination. In the 6th to 8th year, however, savings in treatment and work loss costs compensate vaccination costs, leading to net savings. Over 30 years, average annual varicella costs decrease by 31 % to 33 % to a level between 49 and 51 million €. Sensitivity analyses showed only marginal variations in these results with maximum coverage rate, price of vaccine, and work loss costs being the most influential variables.
Conclusions
Under the current risk-group vaccination strategy, varicella causes a high burden of disease resulting in considerable utilisation of health care resources and related costs. Universal vaccination can effectively reduce morbidity and utilisation. This strategy has a small impact on overall health care costs. For a short time, investment in varicella vaccination causes additional costs, which are low compared to current annual varicella costs, and does not influence sickness funds’ premiums. Reduced morbidity rapidly leads to savings and significant net-savings occur in 6–8 years.