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The goal of this study was to assess the adherence of primary open-angle glaucoma (POAG) patients to medication, and to determine co-factors influencing adherence, using a representative sample of members of the largest German public health insurer. The observational cohort study was based on a longitudinal data set from 2010-2013 and included 250,000 insured persons aged 50 and older with 10,120 diagnosed POAG patients. Uni- and multivariate analysis was performed to investigate several aspects of glaucoma, such as prevalence, adherence, and co-factors influencing adherence. The main outcome measured adherence with prescriptions filled within a year. Multivariate panel regression analysis was used to determine the co-factors influencing this adherence. Prevalence of POAG was 3.36% [CI: 3.28-3.43%], with 2.91% [CI: 2.81-3.01%] for males and 3.71% [CI: 3.61-3.81%] for females, increasing with age. The mean level of adherence in terms of prescriptions filled was 66.5% [CI: 65.50-67.60%]. The results of this analysis revealed a significant influence of age, duration of the disease, care need, distance to death, and multimorbidity as co-factors of non-adherence, whereas gender had no influence. The analysis provided detailed information about POAG health care aspects concerning prevalence and adherence. The most endangered risk groups for non-adherence were patients aged 50-59, patients older than 80 years, patients with a longer duration of POAG, patients with care needs, and patients with three or more severe diseases in addition to glaucoma. To know the predictors responsible for an increased risk to develop POAG is of importance for all persons involved in health care management. Therefore effective strategies to increase awareness of patients and medical care personnel about non-adherence and the importance of a regular and continuous medication to avoid further nerve fiber damage and possible blindness have to be developed.

During hospital treatment, dementia represents an additional challenge for nursing and medical staff. In the context of demographic ageing, this article uses AOK health claims data to project the future number of selected diagnosis groups recorded on the inpatient level. Analyses are carried out separately for persons with and without dementia. The results reveal signifcant differences, showing considerably higher number of diagnoses among persons with dementia. The changing patterns of demand may serve as a basis for estamating financial consequences and necessary investments.

Despite considerable changes in family forms during the past decades, the influence of family on health is strong and persistent. All over Europe the elderly still live in more traditional family forms related to marriage and their family biographies are closely tied to the civil status of their partnership.

This keynote chapter provides an overview of research into the relationship between health and gender/sex. Since health has multiple dimensions, several measures are needed to capture variations by gender and the use of multiple measures can help us better understand the underlying explanations for gender differences. Although life expectancy and mortality are the most extreme measures of health, relative to most other health metrics they are more amenable to accurate measurement, and are more comparable across countries and over time. We start with a review of the existing literature on sex differences in survival followed by a review of the empirical evidence on gender differences in objective and subjective health. Data on objective health are collected through physical performance tests or cognitive tests, or are based on medical diagnoses that are either recoded in administrative databases or collected through self-reports of diagnoses made by physicians. Subjective health measures strongly depend on individual perceptions that can be modified by contextual factors (socioeconomic, cultural, gender roles, etc.) and awareness of objective health status. We focus on three main subjective health indicators: self-perceived health, functional status, and health-related quality of life (HRQOL). These indicators have become core components of epidemiological, social, and economic research. Later in this chapter, we review the most frequently cited explanations for gender differences in health and mortality, grouping them into the following categories: biological (genetic and hormonal), lifestyle factors (tobacco and alcohol consumption, diet, and physical activity), and social profiles (education and employment). Finally, we conclude by providing possible directions for future research in this area.

This study extends the institutionalization hypothesis which proposes that in societies with a more flexible value climate, well-being is less influenced by living in a non-traditional family form. Using data from the EU-SILC 2012 about self-rated health at ages 30–59 we explore twelve European countries representing different welfare state regimes. We characterize household arrangements by an individual’s position within the household which is defined by whether the person shares a household with a partner, children, or another person outside the family nucleus. In addition, we distinguish whether partners live in a consensual union or in a marriage. We test whether self-rated health is associated with the frequency of a certain household arrangement in a given country and hypothesize that higher frequencies of non-traditional household arrangements should go hand in hand with better health.

Demenzen sind einer der haufigsten Erkrankungen im Alter mit hohen Kosten fur die Gesellschaft. Wahrend in der Demenzforschung vaskulare Risikofaktoren im mittleren Lebensabschnitt im Vordergrund stehen, weitet dieser Beitrag den Blick auf die Lebensphase um den Zeitpunkt der Geburt aus. Wir stellen kurz die Theorien der metabolischen Programmierung des Fotus durch Umwelteinflusse (fetal programming), des Missverhaltnisses von Umwelteinflussen wahrend der Entwicklung des Fotus und der ersten Lebensjahre (thrifty phenotype) sowie der Lebenslaufepidemiologie vor. Unsere eigene empirische Studie beruht auf dem Geburtsmonat, einem exogenen Indikator fruher Lebensumstande. Wir besprechen den theoretischen Hintergrund dieses Indikators sowie Forschungsergebnisse zu weiteren exogenen Indikatoren wie Hungersnote, Epidemien und makro-okonomische Fluktuationen. Auf Basis von Daten der grosten gesetzlichen Krankenversicherung in Deutschland finden wir ein signifikant niedrigeres Demenzrisiko fur die im Winter Geborenen. Wir diskutieren Vor – und Nachteile von Abrechnungsdaten fur die Demenzforschung und prasentieren Forschungsergebnisse zu biologischen Mechanismen, die den von uns gefundenen Zusammenhang erklaren konnen.

The FCC-ee study is investigating the design of a 100 km e⁺/e⁻ circular collider for precision measurements and rare decay observations in the range of 90 to 350 GeV center of mass energy with luminosities in the order of 10³⁵ cm⁻²s⁻¹. In order to reach such performances, an extreme focusing of the beam is required in the interaction regions with a low vertical beta function of 2 mm at the IP. Moreover, the FCC-ee physics program requires very low emittances never achieved in a collider with 1.3 nm for ε_{x} and 2 pm for ε_{y} at 175~GeV, reducing the coupling ratio to around 2/1000. With such requirements, any field errors and sources of coupling will introduce spurious vertical dispersion which degrades emittances, limiting the luminosity of the machine. This study describes the status of the tolerance study and the impact of errors that will affect the vertical emittance. In order to preserve the FCC-ee performances, in particular ε_{y}, a challenging correction scheme based on dispersion free steering and linear coupling correction is proposed to keep the coupling and the vertical emittance as low as possible., Proceedings of the 58th ICFA Advanced Beam Dynamics Workshop on High Luminosity Circular e^+e^- Colliders, eeFACT2016, Daresbury, UK