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Few studies and almost exclusively from the USA have recently investigated mobile phone and computer use among users of psychiatric services, which is of high relevance regarding the increasing development of digital health applications and services.Objective, design and settingIn a cross-sectional patient survey, we examined (a) rates and purposes of mobile phone, computer, internet and social media use, and (b) the role of social and clinical predictors on rates of utilisation among psychiatric inpatients in Berlin, Germany.Participants and resultsDescriptive analyses showed that among 496 participants, 84.9% owned a mobile phone and 59.3% a smartphone. Among 493 participants, 68.4% used a computer regularly. Multivariate logistic regression models revealed being homeless, diagnosis of a psychotic illness, being of older age and a lower level of education to be significant predictors for not owning a mobile phone, not using a computer regularly or having a social media account, respectively.ConclusionsUsers of psychiatric services may have access to mobile phones and computers, although rates are lower than in the general population. However, key barriers that need to be addressed regarding the development of and engagement with digital health interventions are factors of social exclusion like marginalised housing as well as clinical aspects like psychotic illness.

Zusammenfassung Hintergrund In Deutschland leben Schätzungen zufolge zwischen 337.000 und 650.000 wohnungslose Menschen in gesundheitlich zumeist prekärer Lage. Studien zu ihrer Gesundheit sind selten und methodisch heterogen. Bisherige Übersichtsarbeiten fokussierten auf psychische Erkrankungen. Fragestellung Ziel der Arbeit ist es, einen Überblick über die aktuelle Forschung zu somatischen Erkrankungen von Wohnungslosen in Deutschland zu geben. Methoden Auf Grundlage einer systematischen Literaturrecherche für die Jahre 2009–2019 werden methodisches Vorgehen, Stichprobenzugang und Rekrutierung sowie die berichteten Gesundheitsaspekte betrachtet. Ergebnisse Es wurden 8 Journalbeiträge mit Peer-Review identifiziert. Häufig wurde der Begriff „Wohnungslosigkeit“ nicht operationalisiert. Im Durchschnitt waren die Wohnungslosen 40,9–67 Jahre alt, der Frauenanteil lag bei 0–35,3 %. Der Stichprobenzugang erfolgte in Unterkünften und im Rahmen medizinischer Angebote. Eine Rekrutierungsstrategie war ein modifiziertes Schneeballsystem („respondent driven sampling“) in Verbindung mit Anreizen (Incentives). Häufig wurden Herz-Kreislauf-Erkrankungen (17–37,2 %), Erkrankungen des Muskel-Skelett-Systems (≥20 %) sowie der Atemwege (7–24 %) berichtet. Abhängig vom Ort der Rekrutierung traten vermehrt Infektionskrankheiten auf (Tuberkulose, Hepatitis B und C). Diskussion Studien zur somatischen Gesundheit Wohnungsloser sind häufig selektiv. Überrepräsentiert erscheinen Personen, die älter sind, unteren Bildungsgruppen angehören oder in deutschen Großstädten lebende Männer. Der Begriff „Wohnungslosigkeit“ wird nicht einheitlich verwendet. Im Vergleich mit repräsentativen Bevölkerungsdaten für Deutschland werden erhöhte Erkrankungsrisiken beobachtet. Kohortencharakteristika können diese nur bedingt erklären. Biografische und intersektionale Ansätze werden benötigt, um die multiplen und kumulativen Belastungslagen zu erfassen.

BACKGROUND Few studies and almost exclusively from the US have recently investigated mobile phone and computer use among users of psychiatric services, which is of high relevance regarding the increasing development of digital health applications and services. OBJECTIVE In this cross-sectional patient survey, we examined the use of digital devices among psychiatric inpatients and identified possible predictors for not owning and using digital devices. METHODS In a cross-sectional patient survey, we examined a) rates and purposes of mobile phone, computer, internet, and social media use and b) the role of social and clinical predictors on rates of utilization among psychiatric inpatients in Berlin, Germany. RESULTS Descriptive analyses showed, that among 496 participants, 84.9% owned a mobile phone, and 59.3% a smartphone. Among 493 participants, 68.4% used a computer regularly. Multivariate logistic regression models revealed being homeless, diagnosis of a psychotic illness,being of older age and a lower level of education to be significant predictors for not owning a mobile phone respective not using a computer regularly or having a social media account. CONCLUSIONS Users of psychiatric services may have access to mobile phones and computers, although rates are lower than in the general population. However, key barriers that need to be addressed regarding the development of and engagement with digital health interventions, are factors of social exclusion like marginalized housing as well as clinical aspects like psychotic illness.

Purpose: Given the psychosocial burdens patients in advanced stages of cancer face, innovative care concepts are needed. At the same time, such vulnerable patient groups are difficult to reach for participation in intervention studies and randomized patient inclusion may not be feasible. This article aims to identify systematic biases respectively selection effects occurring during the recruitment phase and to discuss their potential causes based on a non-randomized, multicenter intervention study with patients in advanced stages of cancer.Methods: Patients diagnosed with at least one of 16 predefined cancers were recruited at four hospitals in three German cities. The effect of social care nurses’ continuous involvement in acute oncology wards was measured by health-related quality of life (EORTC QLQ-C30) and other patient-reported outcomes. Absolute standardized mean difference was calculated as a standardized effect size to test baseline characteristics balance between the intervention and control groups.Results: The study enrolled 362 patients, 150 in the intervention and 212 in the control group. Except for gender, both groups differed in relevant socio-demographic characteristics, e.g. regarding age and educational background. With respect to the distribution of diagnoses, the intervention group showed a higher symptom burden than the control group. Moreover, the control group reported better quality of life at baseline compared to the intervention group (52.6 (SD 21.7); 47.8 points (SD 22.0), ASMD=0.218, p=0.044). Conclusion: Overall, the intervention group showed more social and health vulnerability than the control group. Among other factors, the wide range of diagnoses included and structural variation between the recruiting clinics increased the risk for bias. We recommend a close, continuous monitoring of relevant social and health-related characteristics during the recruitment phase as well as the use of appropriate statistical analysis strategies for adjustment, such as propensity score methods. Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00013640); registered on 29th December 2017.

Purpose Given the psychosocial burdens patients in advanced stages of cancer face, innovative care concepts are needed. At the same time, such vulnerable patient groups are difficult to reach for participation in intervention studies and randomized patient inclusion may not be feasible. This article aims to identify systematic biases respectively selection effects occurring during the recruitment phase and to discuss their potential causes based on a non-randomized, multicenter intervention study with patients in advanced stages of cancer. Methods Patients diagnosed with at least one of 16 predefined cancers were recruited at four hospitals in three German cities. The effect of social care nurses’ continuous involvement in acute oncology wards was measured by health-related quality of life (EORTC QLQ-C30), information and participation preferences, decisional conflicts, doctor-patient communication, health literacy and symptom perception. Absolute standardized mean difference was calculated as a standardized effect size to test baseline characteristics balance between the intervention and control groups. Results The study enrolled 362 patients, 150 in the intervention and 212 in the control group. Except for gender, both groups differed in relevant socio-demographic characteristics, e.g. regarding age and educational background. With respect to the distribution of diagnoses, the intervention group showed a higher symptom burden than the control group. Moreover, the control group reported better quality of life at baseline compared to the intervention group (52.6 points (SD 21.7); 47.8 points (SD 22.0), ASMD = 0.218, p = 0.044). Conclusion Overall, the intervention group showed more social and health vulnerability than the control group. Among other factors, the wide range of diagnoses included and structural variation between the recruiting clinics increased the risk for bias. We recommend a close, continuous monitoring of relevant social and health-related characteristics during the recruitment phase as well as the use of appropriate statistical analysis strategies for adjustment, such as propensity score methods. Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00013640); registered on 29th December 2017.

Background: Homelessness is often described as both a driver and a consequence of poor health, social exclusion and economic marginalisation. The present protocol provides a detailed description of the study Examining the health situation of homeless people in Berlin: a retrospective analysis of data from the health centre for the homeless of the Jenny De la Torre Foundation from 2006 to 2020 (GIG study). The primary objective of the GIG study is to describe and analyse the social and health situation of homeless people in Berlin. Methods: A retrospective secondary data analysis of an anonymous full census of medical records for the years 2006 until 2020 from a health centre for homeless people will be carried out. The main outcome is the description and analysis of the social and health situation of homeless people in Berlin. Total and cross-sectional sample characteristics will be presented in a descriptive analysis using Chi-Square Test, Mann-Whitney-U-Test or independent t-Test as appropriate to test (sub)group differences. Further, outcomes will be analysed using finite mixture modelling in order to distinguish different types of social and health conditions. Latent variable regressions will be applied in order to identify sociodemographic and disease-related factors associated with decreasing health conditions.Discussion: Given the high number of homeless individuals in Germany, it is of great importance to examine their social and health situation in order to gain a better understanding of challenges and needs of homeless people and work on new approaches and solutions to effectively address these.Trail Registration: The study was prospectively registered with the German Clinical Trials Register (trial registration number: DRKS00021172). Registered 26 June 2020,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021172

According to estimates, between 337,000 and 650,000 people in Germany live without a permanent residence. They are highly deprived in terms of health. Studies on the health situation are rare and methodologically heterogeneous. Previous reviews have focused on mental illness.The aim of this paper is to provide an overview of current research on somatic diseases of homeless people in Germany.Based on a systematic literature review for the years 2009-2019, the methodological approaches, sample access, recruitment, and health aspects reported in the studies are compared.By means of a systematic literature search, eight peer-reviewed journal articles were identified. Often the term "homelessness" was not operationalised. The average age of homeless participants was between 40.9 years and 67 years, and the proportion of women was between 0 and 35.3%. Frequently the sample was taken from accommodation and medical services for homeless people. One recruitment strategy was "respondent-driven sampling" in conjunction with incentives. The respondents most frequently reported cardiovascular diseases (17%-37.2%), musculoskeletal diseases (≥20%), and respiratory diseases (7%-24%). Depending on the recruitment site, infectious diseases were common (tuberculosis, hepatitis B and C).Somatic health studies of homeless people are often selective. Older men with lower educational backgrounds living in large German cities appear to be overrepresented, and there is no uniform use of the term "homelessness." Compared with representative population data for Germany, increased risks of somatic illness were observed; cohort characteristics can explain these to a limited extent. Biographical and intersectional approaches are needed to capture multiple and cumulative exposure situations in homelessness.

BackgroundPatient-reported outcome measures (PROMs) are commonly used and are surrogates for clinical outcomes in cancer research. In the research setting of very severe diseases such as cancer, it is difficult to avoid the problem of incomplete questionnaires from drop-out or missing data due to patients who deceased during observation period. We aimed to explore patient characteristics and patient-reported outcomes associated with the time-to-dropout. MethodsIn the Oncological Social Care Project (OSCAR) study the condition of participants was assessed four times within 12 months (t0: baseline, t1: 3 months, t2: 6 months, and t3: 12 months) by validated PROMs. We performed competing-risks regression based on Fine and Gray’s proportional sub-distribution hazards model for exploring factors associated with time-to-dropout. Death was considered as competing risk. ResultsThree hundred sixty-two participants were analyzed in the study. 193 (53.3%) completed follow-up at 12 months, 67 (18.5%) patients dropped out, and 102 patients (28.2%) died during the study period. Poor subjective social support was related to higher risk for drop-out (SHR=2.10; 95%CI: 1.01 – 4.35). Lower values in health-related quality of life were related to drop-out and death. The subscales global health status/QoL, role functioning, physical functioning, and fatigue symptom in the EORTC QLQ-C30 were key characteristics associated with early drop-out.ConclusionSeverely affected cancer patients with poor social support and poor quality of life seem more likely to drop out of studies compared to patients with higher levels of social support and quality of life. This should be considered when planning studies assessing cancer patients. Methods to monitor drop-outs timely and handle missing outcomes might be used. Results of such studies have to be interpreted with caution in light of the particular drop-out mechanisms.

To analyse trends in quality of life (QoL) development among older stroke patients within the first year after rehabilitation discharge, and to investigate the impact of including proxy interviews in research and practice.A prospective cohort study with follow-up at 3, 6, and 12 months with 411 patients and proxy respondents was conducted. The EUROHIS-QOL 8-item index was used to assess QoL. By performing descriptive analyses, QoL development over time was compared among subgroups. Linear mixed models were calculated to estimate mean changes from baseline to 12-month follow-up. The effects of patient characteristics and time on QoL were investigated using comprehensive mixed models.One year after rehabilitation discharge, the majority of patients had neither maintained nor regained their initial QoL. Proxy respondents reported significantly lower QoL (22.6-29.5 points,Quality of life scores reported at the time of rehabilitation discharge are often not lasting. Including severely impaired patients via proxies reduces the risk of overestimating QoL outcomes. Outpatient's characteristics should be taken into account when planning therapy strategies to maintain previously achieved health goals. Regular re-assessments are required.Implications for rehabilitationThere should be an awareness that improvements in quality of life (QoL) achieved during rehabilitation are not sustainable.Regularly re-assessing pain status, psychological burden, and social network size could help clinicians to determine treatment strategies for maintaining and improving rehabilitation achievements.Conducting proxy interviews is required to assess disease burden of patients with severe stroke (e.g., non-linguistic patients).

Automated vehicles (AVs) have left the laboratories and can be experienced in several projects, e.g. at the premises of a clinic in Germany. With this transition, research on AV attitudes no longer needs to rely on questionnaires with hypothetical scenarios and simulations. Previous research – limited by the unavailability of AVs – has provided ambivalent results regarding age and gender differences in attitudes towards AVs. We present research results about the role of age and gender in connection with attitudes such as acceptance, perceived safety, and trust, as well as intention to use. We additionally demonstrate relationships between those constructs and emotions such as amusement, fear, and surprise. Data were collected from participants (n = 125) after having experienced an AV ride with level 4 automation on two campuses of a clinic in Berlin, Germany. Results reveal strong correlations between all attitudes (0.55 ≤ r ≤ 0.71; p

Evaluation of German-language guidelines for aphasia and dysarthria rehabilitation, and comparison with international guidelines.The quality of the 6 included guidelines, as found through a comprehensive literature search, was sytematically evaluated using AGREE II. Quality ratings were compared to the results of a systematic review of 19 English-language guidelines.The quality of German-language guidelines was heterogeneous. In 2 out of 6 evaluation domains and in the overall assessment, no German-language guideline reached the cut-off of 66,67% for good guideline quality. Apart from the domain Editorial Independence, results remained behind those of the international reference guidelines.In some cases, quality can be improved by simple means. It is more resource-intensive, but crucial to document search strategies and how evidence was used in guideline development. A harmonization of the German-language guidelines seems desirable.ZIEL: Evaluation deutschsprachiger Leitlinien zur Aphasie- und Dysarthriebehandlung im Vergleich mit internationalen Leitlinien.Die nach strukturierter Recherche eingeschlossenen 6 deutschsprachigen Leitlinien wurden mit AGREE II evaluiert und den Ergebnissen eines systematischen Reviews von 19 englischsprachigen Leitlinien gegenübergestellt.Die Qualität der deutschsprachigen Leitlinien erwies sich als heterogen. In 2 von 6 zu evaluierenden Domänen sowie in der Gesamtbewertung konnte keine der deutschsprachigen Leitlinien den Cut-Off-Wert von 66,67% für gute Leitlinienqualität erreichen. Mit Ausnahme der Domäne Redaktionelle Unabhängigkeit blieben diese auch unter den Wertungen der internationalen Referenzen.Die Qualität kann teilweise mit einfachen Mitteln erhöht werden. Ressourcenintensiver, aber zentral sind Suchstrategien und Umgang mit recherchierter Evidenz transparent zu machen. Eine Harmonisierung der deutschsprachigen Leitlinien erscheint wünschenswert.

The energy modes for a photonic nanowire have been studied and calculated. We model our photonic crystals after Noda et al. (1999) [18] where logs of semiconductor material are stacked to produce photonic band gaps in both the near and far infrared regions. A nominal dispersion relation was adopted in order to achieve qualitatively useful results. Photonic wires were modeled in two schemes, each with two specific geometries. In the first scheme, a pillar of one photonic crystal is embedded in a larger photonic crystal to produce a wire. This pillar was modeled as having either a square or a circular cross-section. The photonic crystals considered consisted of varying proportions of GaxAl1−xAs, so that the wire could be adjusted. The second scheme investigated was a dielectric material for the central pillar, rather than a photonic crystal. Again, circular and square cross sections were considered. It was found that many more modes fit into the near infrared band gap than the far infrared band gap, and that a circular cross-section permits fewer modes. Finally, a dielectric pillar allows for a wire which is physically much smaller than a wire with a photonic crystal in the middle. As many photonic devices include such wires, these qualitative results could be useful in their design.

To study the eigenvalues of low order singular and non-singular magic squares we begin with some aspects of general square matrices. Additional properties follow for general semimagic squares (same row and column sums), with further properties for general magic squares (semimagic with same diagonal sums). Parameterizations of general magic squares for low orders are examined, including factorization of the linesum eigenvalue from the characteristic polynomial. For nth order natural magic squares with matrix elements 1 , … , n 2 we find examples of some remarkably singular cases. All cases of the regular (or associative, or symmetric) type (antipodal pair sum of 1 + n 2 ) with n - 1 zero eigenvalues have been found in the only complete sets of these squares (in fourth and fifth order). Both the Jordan form and singular value decomposition (SVD) have been useful in this study which examines examples up to 8th order. In fourth order these give examples illustrating a theorem by Mattingly that even order regular magic squares have a zero eigenvalue with odd algebraic multiplicity, m. We find 8 cases with m = 3 which have a non-diagonal Jordan form. The regular group of 48 squares is completed by 40 squares with m = 1 , which are diagonable. A surprise finding is that the eigenvalues of 16 fourth order pandiagonal magic squares alternate between m = 1 , diagonable, and m = 3 , non-diagonable, on rotation by π / 2 . Two 8th order natural magic squares, one regular and the other pandiagonal, are also examined, found to have m = 5 , and to be diagonable. Mattingly also proved that odd order regular magic squares have a zero eigenvalue with even multiplicity, m = 0 , 2 , 4 , . . . Analyzing results for natural fifth order magic squares from exact backtracking calculations we find 652 with m = 2 , and four with m = 4 . There are also 20, 604 singular seventh order natural ultramagic (simultaneously regular and pandiagonal) squares with m = 2 , demonstrating that the co-existence of regularity and pandiagonality permits singularity. The singular odd order examples studied are all non-diagonable.

We have studied energy absorption rate in a quantum dot-metallic nanosphere system embedded on a dielectric substrate. We applied a control field to induce dipole moments in the quantum dot and the metal nanosphere, and monitored the energy absorption using a probe field. These external fields induce dipole moments in the metal nanosphere and the quantum dot, and these two structures interact with one another via the dipole-dipole interaction. The density matrix method was used to evaluate the absorption, indicating that it can be shifted by moving the metal nanosphere close to the quantum dot. Also, absorption efficiency can either be quenched or enhanced by the addition of a metal nanosphere. This hybrid system can be used to create ultrafast switching and sensing nanodevices.

All 8th order Franklin bent diagonal squares with distinct elements 1, …, 64 have been constructed by an exact backtracking method. Our count of 1, 105, 920 dramatically increases the handful of known examples, and is some eight orders of magnitude less than a recent upper bound. Exactly one-third of these squares are pandiagonal, and therefore magic. Moreover, these pandiagonal Franklin squares have the same population count as the eighth order ‘complete’, or ‘most-perfect pandiagonal magic’, squares. However, while distinct, both types of squares are related by a simple transformation. The situation for other orders is also discussed.

Large unit cell calculations of the properties of charged point defects in insulators largely neglect dielectric polarization of the crystal, because the periodically repeated cells are so small. Embedded quantum cluster calculations with shell-model crystals, representing a single defect in a large crystal, are able to represent the polarization more realistically. For such embedded quantum clusters, we evaluate the optical excitation energy for the nitrogen vacancy in charge state (+3): vN3+ in AlN. This is done with and without dielectric polarization of the embedding crystal. A discrepancy of a few per cent is found, when both ground and excited state orbitals are well-localized within the vacancy. We show that the discrepancy rises rapidly as the excited state becomes more diffuse. We conclude that an embedded cluster approach will be required for transitions that involve even somewhat diffuse states. The investigation is based on a new model for AlN that shows promise for quantitative accuracy.

We present energy absorption and interference in a quantum dot-metallic nanosphere system embedded on a dielectric substrate. A control field is applied to induce dipole moments in the nanosphere and the quantum dot, and a probe field is applied to monitor absorption. Dipole moments in the quantum dot or the metal nanosphere are induced, both by the external fields and by each other's dipole fields. Thus, in addition to direct polarization, the metal nanosphere and the quantum dot will sense one another via the dipole-dipole interaction. The density matrix method was used to show that the absorption spectrum can be split from one peak to two peaks by the control field, and this can also be done by placing the metal sphere close to the quantum dot. When the two are extremely close together, a self-interaction in the quantum dot produces an asymmetry in the absorption peaks. In addition, the fluorescence efficiency can be quenched by the addition of a metal nanosphere. This hybrid system could be used to create ultra-fast switching and sensing nanodevices.

Two-particle correlations from RHIC have provided a surprising snapshot of the final state at RHIC. In this talk I discuss the nature of the HBT puzzle and attempt to delineate several factors which might ultimately resolve the issue., Proceedings for WPCF, Kromeriz, Czech Republic, August 2005

We have studied energy transfer and photoluminescence in donor and acceptor quantum dots embedded in a nonlinear photonic crystal. The quantum dots are interacting with each other via the dipole-dipole interaction. The nonlinear photonic crystal modifies the dielectric constant of the hybrid system. Using the density matrix method, it is found that the energy transfer and photoluminescence in the donor quantum dot can be controlled by a pump field due to the nonlinearity of the photonic crystal. Additionally, our theoretical calculations agree with recent experiments. This hybrid system can be used to fabricate ultrafast switching and sensing nanodevices.

We have studied quantum coherence and interference phenomena in a quantum dot (QD)-metallic nanorod (MNR) hybrid system. Probe and control laser fields are applied to the hybrid system. Induced dipole moments are created in the QD and the MNR, and they interact with each other via the dipole-dipole interaction. Using the density matrix method, it was found that the power spectrum of MNR has two transparent, states and they can be switched to one transparent state by the control field. Ultrafast switching and sensing nanodevices could be produced using this model.

We study the coupling between quantum dots through the dipole–dipole interaction in photonic nanofibers manufactured by embedding a dielectric material into a photonic crystal. The embedded dielectric material is doped with an ensemble of three-level quantum dots. A probe field is applied to monitor the absorption, and a control field is applied to induce dipole moments in quantum dots. Dipoles are induced in quantum dots due to the external fields, and they interact with each other via the dipole–dipole interaction. Quantum dots also interact with the nanofiber through the electron–bound photon interaction. The absorption coefficient has been calculated using the density matrix method, and the dipole–dipole interaction has been evaluated in the mean field approximation. It is found that the absorption spectrum splits from one peak to two peaks by the dipole–dipole interaction. The splitting of peaks can be controlled by either the resonance energy of quantum dots or bound photon states of the nanofiber.