Techniker Krankenkasse (Germany)

BackgroundTumor necrosis factor inhibitors (TNFi) are often used in the treatment of autoimmune diseases. Their use during pregnancy, particularly in the 2nd half, has been a matter of debate due to a potential risk of severe infections in infants. We aimed to describe (i) the dispensation of TNFi before and during pregnancy and (ii) the occurrence of hospitalizations with infections among prenatally exposed infants.MethodsUsing the GePaRD database (claims data covering 20% of the German population), we included pregnancies ending in a live birth between 2006 and 2018 in women aged 12–50 years with ≥ 1 dispensation of TNFi in the year before or during pregnancy. We assessed maternal exposure to TNFi and hospitalization with infections among infants in the first year of life.ResultsAmong 1,113 children included, 265 (23.8%) were exposed to TNFi after the 20th gestational week. Among these, the proportion of infants hospitalized due to an infection in the first year of life was 11.7% (95% confidence interval [CI]: 8.4%-16.1%). In 529 children (47.5%), TNFi were dispensed only in the 365 days before pregnancy. Of these, 11.3% (95% CI: 8.9%-14.3%) were hospitalized due to an infection.ConclusionsOur analyses showed that among children whose mothers used TNFi in the year before or during pregnancy, about one fourth was exposed to TNFi in the second half of pregnancy. Among these children, the proportion hospitalized with a severe infection in the first year of life was similar to that from mothers exposed only before pregnancy.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12884-025-08590-0.

The main objective of this article is to contribute to the establishment and dissemination of Biofloc Technology (BFT) in Vocational Education and Training (VET). This technology is presented as a tool to develop knowledge and practice in different techniques related to several VET fields such as Maritime-Fishing, Chemistry, Health, Security and Environment or Food Industry. For this purpose, a table has been elaborated as a guide to get started in the study of this technology. It contains the general information to characterise the main processes within a BFT system: main factors to be measured, the type of sample, main target techniques and equipment and interesting remarks as well as the field of study in VET. Thus, this article highlights the value of BFT as a technology that can enforce collaborative work among different disciplines and can help to increase environmental awareness. Moreover, by implementing BFT, environmental challenges such as food demand and sustainable production of food with high nutritional value and traceability safety.

IntroductionPeople with Parkinson’s disease (PwPD) experience a wide range of motor and non-motor symptoms that have a significant impact on their health and quality of life. Effective care management for PwPD involves monitoring symptoms at home, involving specialised multidisciplinary care providers and enhancing self-management skills. This study protocol describes the process evaluation within a randomised clinical trial to assess the implementation and its impact on patient health outcomes of ParkProReakt—a proactive, multidisciplinary, digitally supported care model for community-dwelling PwPD.Methods and analysisThe hybrid efficacy-implementation study will assess key implementation outcomes using the Medical Research Council framework for complex interventions alongside a randomised controlled trial. A combination of quantitative and qualitative methods will be used to assess process data from care providers and patients. The main process outcomes are fidelity, dose, feasibility and context. Context will be analysed through semistructured interviews and focus groups using the Consolidated Framework of Implementation Research. To elucidate potential facilitators and barriers to implementation and to gain deeper insights into the efficacy outcome data, quantitative and qualitative process data will be integrated at an interpretative level using mixed methods. In addition to process evaluation, potential indirect mechanisms of impact will be measured.Ethics and disseminationEthical approval for this study was obtained from the responsible state medical ethics committees in Hesse and Hamburg, Germany. Results will be communicated to the funding body and disseminated through scientific publications.Trial registrationThis study was registered with the German Registry for Clinical Studies (DRKS)—number: DRKS00031092.

Abdominal pain is a common and often debilitating issue for children and adolescents. In many cases, it is not caused by a specific somatic condition but rather emerges from a complex interplay of bio-psycho-social factors, leading to functional abdominal pain (FAP). Given the complex nature of FAP, understanding its origins and how to effectively manage this condition is crucial. Until now, however, no questionnaire exists that targets knowledge in this specific domain. To address this, the Abdominal Pain Knowledge Questionnaire (A-PKQ) was developed. Two versions were created (one for children and one for parents) and tested in four gastroenterology clinics and one specialized pain clinic in Germany between November 2021 and February 2024. Children between 8 and 17 years of age (N = 128) and their accompanying parents (N = 131) participated in the study. Rasch analysis was used to test the performance of both versions of the questionnaire. The original questionnaires exhibited good model and item fit. Subsequently, both questionnaires were refined to improve usability, resulting in final versions containing 10 items each. These final versions also demonstrated good model and item fit, with items assessing a variety of relevant domains. The A-PKQ is an important contribution to improving assessment in clinical trials focused on pediatric functional abdominal pain.

IBDBIO-ASSIST was a randomised controlled trial assessing the efficacy of care provided by IBD nurse specialists in Germany in improving health-related quality of life (QoL) in IBD patients on biologic therapy. To evaluate patient-related outcomes and economic consequences associated with integrating IBD nurses into usual care. We randomly assigned 1086 patients with IBD on biologic therapy to a control group (CG) receiving usual care or an intervention group (IG) receiving additional care from an IBD nurse specialist. The primary outcome was disease-specific QoL (sIBDQ) assessed at 6, 12 and 18 months. At baseline, patients in both groups were highly satisfied with their treatment situation and had relatively high sIBDQ values (range: 1-7; CG: 5.12; IG: 4.92). In the intention-to-treat (ITT) analysis of the overall sample, there was no significant difference in sIBDQ between groups at the assessment time points. However, a per-protocol analysis of patients with impaired QoL at baseline (EQ-VAS < 75 [median]), showed improvement in sIBDQ over 6 months that became significant at month 12 and remained significant through month 18 (baseline: IG 4.24; CG 4.31; 18 months: IG 5.02; CG 4.76; p = 0.017). High baseline satisfaction of IBD patients with treatment and the relatively high baseline sIBDQ values may have contributed to the lack of significant difference in sIBDQ scores for the overall sample. However, patients with impaired QoL derived significant benefit from additional care provided by an IBD nurse specialist, leading to meaningful improvements in sIBDQ over the long term.

Health services research examines the structures and processes of health care under everyday conditions. Routine data of the statutory health insurance (SHI) - the so-called routine practice data - represent real health care and are therefore an important data source for health services research. This paper presents 5 key questions that researchers and data-holding institutions can use to assess the suitability of this data source for answering their health services research question. The aim of these guiding questions is to generate a common understanding between researchers and data-holding institutions of the research project, the research objective, and the feasibility of implementation in health services research. The five guiding questions cover the formulation of the research question, the planned method, the target population, the relevant study periods, and the required information from SHI data. These methodologically oriented guiding questions are supplemented by the question of how the results of the research project could improve care. Thus, for researchers, the five guiding questions provide an initial structuring for data requests; for data-holding institutions, they provide a framework for considering possible involvement in or support of a research idea in health services research.

The local beauty industry is at the peak of its popularity, which is marked by the increasing presence of skincare and makeup brands. Whitelab is a company in the skincare sector implementing a marketing strategy by making Sehun EXO a brand ambassador to be able to influence someone. This is one way for the Whitelab brand to attract consumers. The purpose of this study is to find out how brand ambassadors, purchase intentions, and brand image on Whitelab products, determine the influence of brand ambassadors on brand image, brand ambassadors on purchase intentions, and the influence of brand ambassadors on purchase intentions through brand image. This study uses descriptive analysis and casual relationships, technically using path analysis models and Sobel tests with a total sample of 100 respondents. The population in this study is every individual who knows the Whitelab brand and knows Sehun EXO as the Whitelab brand ambassador. The results of the study show that the Brand ambassador variable has a significant effect on Brand image, the Brand ambassador variable has a significant effect on Purchase intention, and the Brand ambassador variable has a significant effect on Purchase intention through Brand image.

Einleitung Forschungsprojekte zur Notfallversorgung benutzen oftmals GKV-Routinedaten zur Analyse versichertenindividueller Behandlungspfade. Dabei wird die Notfall-Inanspruchnahme ambulant über EBM-GOPs (§295 SGBV) und stationär über den Aufnahmegrund (§301) operationalisiert.

Einleitung Digitale Gesundheitsanwendungen (DiGA) können dazu beitragen, die psychotherapeutische Versorgung und die Versorgungslage zu verbessern und bestehende Herausforderungen zu reduzieren. Das bisherige Verordnungsverhalten deutet jedoch auf Hürden und Hemmnisse hin, die einem bedarfsgerechten Einsatz entgegenstehen. Ziel des Innovationsfondsprojekts DiGAPsy (Kennzeichen: 01VSF22029) ist es, Potenziale von DiGA im Versorgungsprozess psychischer Erkrankungen für eine bedarfsgerechte Versorgung zu ermitteln. Durch die Realisierung dieser soll die Versorgungsqualität verbessert werden.

BackgroundHealthcare for people with somatic and comorbid mental diseases can pose a challenge to the healthcare system. The aim of the SoKo study (the Somatic care of patients with mental Comorbidity) is to assess the current state of care and the facilitators and barriers of somatic care of people with somatic disorders and comorbidity of a mental disorder.MethodsThe study is conducted as a mixed-methods approach and will include (a) descriptive and inferential analysis of secondary claims data of persons insured by a German statutory health insurance company in North Rhine-Westphalia (Techniker Krankenkasse, TK-NRW), (b) qualitative individual interviews and group discussions, and (c) based on (a) and (b), quantitative surveys of both patients and physicians. We intend to analyse a sample of claims data of about 2.6 million persons insured by TK-NRW (group comparisons between TK-NRW insured persons with a diagnosis of a prevalent somatic disease [ICD-10-GM E01–E07, E11, E66, I10–I15, I20–I25, I60–I64] with and without comorbidity of a mental disorder [F00–F99]), in order to assess the uptake of somatic care by people with mental and somatic comorbidity. In addition, primary data from patients with the aforementioned somatic illnesses and a mental comorbidity as well as primary data from physicians (general practitioners and medical specialists) will be collected. The focus here will be on support factors and barriers in the somatic care of people with mental comorbidity.DiscussionUp to now, there have been no published results of a systematic collection of both secondary and primary data on the utilisation of different care services of somatically ill patients with mental comorbidity for Germany. The present mixed-methods study aims to address this gap.Trial registrationThe trial is registered with the German Clinical Trials Register DRKS: DRKS00030513. The trial was registered on 3rd February 2023.