Background: Despite the increasing demand for acupuncture and homoeopathy in Germany, little is known about the effects of these treatments in routine care. We set up a pragmatic documentation study in general practice funded within the scope of project launched by a German health insurer. Patients were followed-up for up to four years.
Influence of the barrier height on carrier recombination and transparency density in GaN-based laser structures
For the first time, the therapeutic effects on subacute and chronic tinnitus of an inpatient multimodal treatment concept based on principles of Ericksonian hypnosis (EH) were examined by standardized criteria of the Tinnitus Questionnaire (TQ) and Health Survey (SF-36) within a controlled prospective, longitudinal study. A total of 393 patients were treated within an inpatient closed-group 28-day-setting based on a resource-oriented, hypnotherapeutic concept. The severity of tinnitus was assessed by TQ at times of admission, discharge and also at a 6- and 12-month follow-up. Health-related quality of life was evaluated before and after therapy using the SF-36. After therapy, a decrease in TQ score was seen in 90.5% of the patients with subacute tinnitus and in 88,3% of those with chronic tinnitus. Assessment of the TQ score at the end of therapy revealed highly significant improvements of 15.9/14.1 points in mean. Effect sizes in the treatment groups (0.94/0.80) were superior to those in the waiting-list controls (0.14/0.23). The TQ score remained stable in the follow-up controls. Significant improvement in health-related quality of life has been observed within the treatment groups depending on initial level of tinnitus serverity I-IV according to TQ. Using a multimodal treatment concept with emphasis on resource-activating approaches of EH the annoyance of tinnitus can be significantly reduced while health-related quality of life is enhanced within a comparatively short treatment period of 28 days.
We performed systematic studies of the optical gain and its saturation in (In,Ga)N/GaN/(Al,Ga)N laser structures in dependence on photon energy, excitation density and number of quantum wells. The optical gain and its saturation were obtained by means of the variable stripe-length method under quasi-stationary conditions. The unsaturated gain factor increases with increasing excitation power, i.e increasing modal gain, and reaches its maximum at energies slightly below the spectral position of the gain maximum. High unsaturated gain factors of up to 40 dB at 300 K have been measured.A semiconductor optical amplifier is of general importance in photonics because it is a basic component in most photonic integrated circuits and optical fiber systems [1, 2]. Knowledge of its saturation behavior, in particular the maximum unsaturated modal gain, is important for optical communications. Despite this, a detailed investigation of the saturation behavior of (In,Ga)N/GaN/(Al,Ga)N based optical amplifiers is still lacking.Saturation of an optical amplifier could be caused for two reasons: First, if the stimulated-emission rate, caused by amplification of an input pulse, becomes comparable with the spontaneous and nonradiative recombination in the amplifier, the electron± hole pair density is reduced and saturation sets in. This mechanism limits the maximum unsaturated output power of the amplifier. Second, saturation could be already caused by the internal noise, i.e. spontaneous emission, which is also present without an input signal. The fraction of the spontaneous emission which is coupled into the guided amplifier mode is determined by the spontaneous emission factor b [3]. Amplified spontaneous emission (ASE) of these photons could lead itself to saturation and limits the unsaturated modal gain of the amplifier device.We investigated the gain saturation behavior without external input signal, by systematic studies of (In,Ga)N/GaN/(Al,Ga)N laser structures in dependence on photon energy, excitation density, and number of quantum wells.The structures were grown on SiC substrates by metal organic chemical vapor deposition. The samples consisted of a (Al,Ga)N cladding layer, a GaN waveguide layer, an active layer of (In,Ga)N wells, an (Al,Ga)N spacer layer, a GaN waveguide layer, and an (Al,Ga)N cladding layer. Samples with periods of 3, 4, 5, and 10 2 nm thick P. Michler et al.: Gain Saturation in (In,Ga)N/GaN/(Al,Ga)N Laser Structures 391
Increasing concerns about climate change imply that decisions on the digitization of healthcare should consider evidence about its carbon footprint (CF). This study aims to develop a transparency catalogue for reporting CF calculations, to compare results, and to assess the transparency (reporting quality) of the current evidence of virtual care (VC) intervention. We developed a checklist of transparency criteria based on the consolidation of three established standards/norms for CF calculation. We conducted a systematic review of primary studies written in English or German on the CF of VC interventions to check applicability. Based on our checklist, we extracted methodological information. We compared the results and calculated a transparency score. The checklist comprises 22 items in the aim, scope, data and analysis categories. Twenty-three studies out of 1466 records were included, mostly addressing telemedicine. The mean transparency score was 38% (minimum 14%, maximum 68%). On average, 148 kg carbon dioxide equivalents per patient were saved. Digitization may have co-benefits, improving care and reducing the healthcare CF. However, the evidence for this is weak, and CF reports are heterogeneous. Our transparency checklist may serve as a reference for developing a standard to assess the CF of virtual and other healthcare and public health services.
PACS: 78.45.þh; 78.66.Fd A simple model for the analysis of the optical gain and its saturation will be presented. Our experimental results show that the conventional saturation term based on the assumption of a linear differential gain behavior is improper to describe the measured data of GaN-based quantum-well structures. An analytical description of gain saturation and the amplified spontaneous emission intensity is quite suitable to explain the experiments. The results fit very well to the data that we obtained by use of the variable stripe-length method. They yield further information about the saturation process which will be discussed in detail.
Schools of economic ethics inspired by Buchanan propose viewing ethical conflicts as prisoners’ dilemmas (PDs) to facilitate solutions based on Pareto-improving institutional changes. Given that healthcare is determined by complex institutional arrangements, it has been claimed that this approach is also suitable for business ethics in healthcare. To scrutinize this claim, this research systematically searched for studies reporting PD structures in healthcare. PubMed, EconLit, and EconBiz were searched to find articles in German and English. Study type, characteristics of the game, and the proposed means to overcome the dilemma (if mentioned) were extracted and analyzed for aspects supporting or challenging the claim. Across 53 studies, 68 descriptions of various dilemmas in healthcare and public health were identified. Many authors successfully developed proposals for institutional change to overcome these dilemmas. However, many of these analyses exhibited limitations such as oversimplifications or inconsistencies. Also, the quality of evidence on both the characteristics of dilemmas and the effectiveness of proposed solutions was very poor. The subsamples of studies that explicitly cited the ethical approach were disjunct from those that applied empirical methods to analyze the dilemmas (frequently applying empirically richer frameworks than rational choice only). The large number of identified PDs indicates that economic ethics is relevant to healthcare. However, there is a need for further evidence to substantiate both the descriptive and prescriptive claims of this ethical theory. It should thus be seen as a complement that needs justification, rather than a substitute superior to other ethical frameworks.
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