Predictors for hospitalization and outpatient visits in patients with inflammatory bowel disease: results from the Swiss Inflammatory Bowel Disease Cohort Study

OBJECTIVES Patients with inflammatory bowel disease (IBD) have a high resource consumption, with considerable costs for the healthcare system. In a system with sparse resources, treatment is influenced not only by clinical judgement but also by resource consumption. We aimed to determine the resource consumption of IBD patients and to identify its significant predictors. MATERIALS AND METHODS Data from the prospective Swiss Inflammatory Bowel Disease Cohort Study were analysed for the resource consumption endpoints hospitalization and outpatient consultations at enrolment [1187 patients; 41.1% ulcerative colitis (UC), 58.9% Crohn's disease (CD)] and at 1-year follow-up (794 patients). Predictors of interest were chosen through an expert panel and a review of the relevant literature. Logistic regressions were used for binary endpoints, and negative binomial regressions and zero-inflated Poisson regressions were used for count data. RESULTS For CD, fistula, use of biologics and disease activity were significant predictors for hospitalization days (all P-values <0.001); age, sex, steroid therapy and biologics were significant predictors for the number of outpatient visits (P=0.0368, 0.023, 0.0002, 0.0003, respectively). For UC, biologics, C-reactive protein, smoke quitters, age and sex were significantly predictive for hospitalization days (P=0.0167, 0.0003, 0.0003, 0.0076 and 0.0175 respectively); disease activity and immunosuppressive therapy predicted the number of outpatient visits (P=0.0009 and 0.0017, respectively). The results of multivariate regressions are shown in detail. CONCLUSION Several highly significant clinical predictors for resource consumption in IBD were identified that might be considered in medical decision-making. In terms of resource consumption and its predictors, CD and UC show a different behaviour.

Change in positive affect during outpatient cardiac rehabilitation predicts vital exhaustion in patients with coronary heart disease

Vital exhaustion is an acknowledged psychosocial risk factor of incident coronary heart disease (CHD) and recurrent CHD events. Little is known about trajectories in vital exhaustion in patients with CHD and the factors predicting this change. We hypothesized that vital exhaustion would decrease during outpatient cardiac rehabilitation and that an increase in positive affect over time would be associated with decreased vital exhaustion at discharge from cardiac rehabilitation. We also explored the role of the patient's sex in this context. Vital exhaustion was reduced during outpatient cardiac rehabilitation, especially in patients who experienced an increase in positive affect over time (p < .001). This relationship was significant in men (p < .001) but not in women (p = .11).

Versuch einer Geschichte der Juden in Sina

abweichender Titel des beigefügten Werkes: Nachrichten von den heiligen Büchern der Synagoge zu Cai-fong-fu, der Hauptstadt der Provinz Ho-nan

Stilus – calamus – griffel – stift. Zur metonymischen Metaphorik des Stilbegriffs in der mittellateinischen und mittelhochdeutschen Literatur

„Die Übertragung der Bezeichnung für den Schreibgriffel auf die Verfasstheit geschriebener Texte“ scheint bis zum Ende der Antike, ja bis ins 14. Jahrhundert „noch als Metapher erfahren worden zu sein“ (H.-U. Gumbrecht zur Geschichte des Stilbegriffs in ders./K. Ludwig Pfeiffer (Hg.), Stil. Geschichte und Funktionen eines kulturwissenschaftlichen Diskurselements, Frankfurt/M. 1986 [stw 633], S. 735 und 741). Der angebotene Beitrag verifiziert diese These am Beispiel aussagekräftiger Textstellen der mittellateinischen und der mittelhochdeutschen Literatur, in denen Schreibgeräte (wie stilus, calamus, griffel, stift) im Kontext inszenierter Schreib- und Lebens-‚Stile’ stehen. Als Werkzeug des Schreibens ist der stilus eine Verlängerung der Hand, des Körpers, aber auch des Habitus, der Lebensart seines Besitzers oder seiner Besitzerin. Die herangezogenen Textbeispiele stammen aus Alanus’ ab Insulis ›Anticlaudianus‹ (Anrufung des Phoebus), aus Konrad Flecks ›Flore und Blanscheflur‹ (der Griffel als Minnebote) sowie aus Heinrichs von Mügeln Spruchdichtung und Johannes’ von Tepl ›Ackermann‹ (stift und stipulus als Operatoren dichterischer Gestaltung).

Still'jestand'n! Reaktionäre Offziers, zum Flötenjehn rückwärts richt't Euch! Marrsch! Ene heilsame Exerzier-Uebung: Meine Herrn Offzierkens vont reaktionäre Vollblut! ...

Welsch (Projektbearbeiter): Die nach der verheerenden Niederlage von 1806 von Stein und Scharnhorst auf den Weg gebrachten Reformen haben in den Jahren 1813 - 1815 den preußischen Staat samt Thron vor dem Untergang bewahrt. Nach 1815 jedoch wurde die Trennung von Adel und "Karnalje" wieder in Kraft gesetzt, bis 1848 die Völker aus 33jährigem Schlafe erwachten. Für reaktionäre Offiziere, die auf ihren alten Privilegien bestehen, ist in der jetzigen Zeit kein Platz mehr

Ausst. 320 - Ablaßbrief aus Anlaß des Jubeljahres. 1480

Vorbesitzer: Hans (Johannes) von Sorgenloch genannt Gänsfleisch (Surgenloch dictus Ginßfleiß)

Geochemical provenance analysis of fine-grained sediment of sediment core AND1-1

Bulk chemical fine-grained sediment compositions from southern Victoria Land glacimarine sediments provide significant constraints on the reconstruction of sediment provenance models in the McMurdo Sound during Late Cenozoic time. High-resolution (~ 1 ka) geochemical data were obtained with a non-destructive AVAATECH XRF Core Scanner (XRF-CS) on the 1285 m long ANDRILL McMurdo Ice Shelf Project (MIS) sediment core AND-1B. This data set is complemented by high-precision chemical analyses (XRF and ICP-OES) on discrete samples. Statistical analyses reveal three geochemical facies which are interpreted to represent the following sources for the sediments recovered in the AND-1B core: 1) local McMurdo Volcanic Group (MVG) rocks, 2) Transantarctic Mountain rocks west of Ross Island (W TAM), and 3) Transantarctic Mountain rocks from more southerly areas (S TAM). Data indicate in combination with other sediment facies analyses (McKay et al., 2009, doi:10.1130/B26540.1) and provenance scenarios (Talarico and Sandroni, 2009, doi:10.1016/j.gloplacha.2009.04.007) that diamictites at the drill site are largely dominated by local sources (MVG) and are interpreted to indicate cold polar conditions with dry-based ice. MVG is interpreted to indicate cold polar condition with dry-based ice. A mixture of MVG and W TAM is interpreted to represent polar conditions and the S TAM facies is interpreted to represent open-marine conditions. Down-core variations in geochemical facies in the AND-1B core are interpreted to represent five major paleoclimate phases over the past 14 Ma. Cold polar conditions with major MVG influence occur below 1045 mbsf and above 120 mbsf. A section of warmer climate conditions with extensive peaks of S TAM influence characterizes the rest of the core, which is interrupted by a section from 525 to 855 mbsf of alternating influences of MVG and W TAM.