Leadership position and physician visits – results of a nationally representative longitudinal study in Germany

Background

So far, studies within the occupational field have largely concentrated on working conditions and job stressors and staff members’ or subordinate health. Only a few have focused on managers in this context, but studies are missing that explicitly look at the relation between leadership position and health care use (HCU). Thus, the purpose of this study was to examine the potential effects of a change in leadership position on HCU in women and men longitudinally.

Methods

Data were drawn from a nationally representative longitudinal study in Germany (German Socio-Economic Panel, GSOEP). Data from 2009 and 2013 were used. Leadership position was divided into (i) top management, (ii) middle management, (iii) lower management, and (iv) a highly qualified specialist position. The number of physician visits in the preceding 3 months were used to quantify HCU (n?=?2140 observations in regression analysis; 69% male).

Results

Adjusting for various potential confounders (e.g., age, self-rated health, chronic conditions, and personality factors), Poisson FE regression analysis revealed that changes from a highly qualified specialist position to the top management were associated with a decrease in the number of physician visits in men (β?=?.47, p?<?.05), but not in women. Gender differences (gender x leadership position) were significant.

Conclusions

Findings of this study emphasize the impact of leadership positions on the number of physician visits in men. Further study is required to elucidate the underlying mechanisms.

     

Pflegeschulungen für Angehörige mit Migrationshintergrund und Kompetenzbildungen für professionell Pflegende

Background

The proportion of people in need of care with a migration background and therefore the demand for qualified nursing staff will increase. So far, however, considerations and concepts aiming to improve the care situation (including cultural sensitivity) for people in need of care with a migration background are lacking.

Objective

The following questions are addressed on the basis of care training for relatives with migration background and competence development for health care professionals: What content should the care training/competence development take into account? What are the limits regarding planning and implementation, and what are the suggestions for improvements?

Materials and methods

The development of care training and competence development was based on a needs and resources assessment (in the form of a systematic literature review, an expert workshop, semistructured interviews with relatives with migration background who are providing nursing care). A training manual that has been published includes research results and findings and is applicable to other target groups and settings.

Results and discussion

A transcultural training manual was developed and tested for use in outpatient care. It consists of two parts: training for relatives providing nursing care and competency training for health care specialists. It enables the planning, preparation, and implementation of training courses and includes theoretical background knowledge, practical exercises, and didactic advice. When using the manual, however, the target group should be planned at an early stage and individual needs and resources of course participants should be taken into account.

     

Effects of high-dose baclofen on cue reactivity in alcohol dependence: A randomized,placebo-controlled pharmaco-fMRI study

Increased functional brain response towards alcohol-associated stimuli is a neural hallmark of alcohol dependence and a promising target for pharmacotherapy. For the first time, we assessed the effects of individually titrated high-dose baclofen on cue reactivity and functional connectivity in alcohol-dependent (AD) patients in a randomized controlled trial (RCT).We investigated 23 recently detoxified AD patients and 23 matched healthy controls (HC) with a cue reactivity functional magnetic resonance imaging task. Patients were further scanned at baseline without medication and during treatment with high-dose baclofen/placebo (30–270 mg/d). Analyses were conducted for alcohol cue-elicited brain response, alcohol cue-modulated and stimulus-independent functional connectivity with left ventral tegmental area (VTA) as seed region.At baseline, AD patients (N?=?23) showed increased cue-elicited brain activation in the ventral striatum (VS) compared to HC (N?=?23), which was decreased at the second scanning session compared to baseline. Patients receiving baclofen (N?=?10) showed a significant stronger decrease in cue-elicited brain activation in left orbitofrontal cortex (OFC), bilateral amygdala and left VTA than patients receiving placebo (N?=?13). Treatment with baclofen further led to a decrease in alcohol cue-modulated functional connectivity between left VTA and left anterior cingulate cortex (ACC) as well as left medial prefrontal cortex (MPFC). Regarding clinical outcome, significantly more patients of the baclofen group remained abstinent during the high-dose period.Baclofen specifically decreased cue-elicited brain responses in areas known to be involved in the processing of salient (appetitive and aversive) stimuli. Treatment with high-dose baclofen seems to provide a pharmacological relief of this neural “warning signal” evoked by alcohol-related cues, thereby possibly supporting patients in remaining abstinent.Trial Registration Identifier of the main trial [BACLAD study] at clinicaltrials.gov: NCT01266655.     

Berberine chloride mediates its antileishmanial activity by inhibiting Leishmania mitochondria

Parasitology Research - Berberine chloride, a plant-derived isoquinoline alkaloid, has been demonstrated to have leishmanicidal activity, which is mediated by generation of a redox imbalance and...     

The patients’ view: impact of the extent of resection,intraoperative imaging,and awake surgery on health-related quality of life in high-grade glioma patients—results of a multicenter cross-sectional study

Neurosurgical Review - The objective of the present study is to assess the influence of extent of resection (EoR), use of intraoperative imaging, and awake surgery on health-related quality of life...     

Comparative Analysis of the Reconstruction of Individual Hip Anatomy Using 3 Different Cementless Stem Designs in Patients With Primary Hip Osteoarthritis

Background

We questioned whether there was a radiographic difference in hip geometry reconstruction and implant fixation between 3 different cementless stem design concepts in patients with primary end-stage hip osteoarthritis.