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.

Background Digital public health (DiPH) provides novel approaches for prevention, potentially leading to long-term health benefits in resource-limited health systems. However, cost-effectiveness of DiPH interventions is unclear. This systematized review investigates the use of decision-analytic modelling in health economic evaluations of DiPH primary prevention and health promotion interventions, focusing on intervention’s design, methods used, results, and reporting quality. Methods PubMed, CINAHL, and Web of Science were searched for studies of decision-analytic economic evaluations of digital interventions in primary prevention or health promotion, published up to June 2022. Intervention characteristics and selected items were extracted based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Incremental cost-effectiveness ratios (ICERs) were then extracted and price-adjusted to compare the economic evaluation results. Finally, the included studies’ reporting quality was assessed by building a score using CHEERS. Results The database search (including search update) produced 2,273 hits. After removing duplicates, 1,434 titles and abstracts were screened. Of the 89 studies meeting the full-text search criteria, 14 were ultimately reviewed. The most common targets were physical activity (five studies) and weight loss (four). Digital applications include text messages, web-based inventions, app-based interventions, e-learning devices, and the promotion of smartphone apps. The mean ICER of the 12 studies using quality-adjusted life years (QALYs) is €20,955 per QALY (min. − €3,949; max. €114,211). The mean of reported CHEERS items per study is 81% (min. 59%; max. 91%). Conclusions This review only includes primary prevention and health promotion, and thus excludes other DiPH fields (e.g. secondary prevention). It also focuses on decision-analytic models, excluding study-based economic evaluations. Standard methods of economic evaluation could be adapted more to the specifics of DiPH by measuring the effectiveness of more current technologies through alternative methods, incorporating a societal perspective, and more clearly defining comparators. Nevertheless, the review demonstrates using common thresholds that the new field of DiPH shows potential for cost-effective preventive interventions.

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

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.

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.

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