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Introduction: Cardiac rehabilitation is designed for patients suffering from cardiovascular diseases or functional disabilities. The aim of a cardiac rehabilitation is to improve overall physical health, psychological well-being, physical function, the ability to participate in social life and help patients to change their habits. Regarding the heterogeneity of these aims measuring of the effect of cardiac rehabilitation is still a challenge. This study recommends a concept to assess the effects of cardiac rehabilitation regarding the individual change of relevant quality indicators.
Methods: With EVA-Reha; cardiac rehabilitation the Medical Advisory Service of Statutory Health Insurance Funds in Rhineland-Palatinate, Alzey (MDK Rheinland-Pfalz) developed a software to collect data set including sociodemographic and diagnostic data and also the results of specific assessments. The project was funded by the Techniker Krankenkasse, Hamburg, and supported by participating rehabilitation centers. From 01. July 2010 to 30. June 2011 1309 patients (age 71.5 years, 76.1% men) from 13 rehabilitation centers were consecutively enrolled. 13 quality indicators in 3 scales were developed for evaluation of cardiac rehabilitation: 1) cardiovascular risk factors (blood pressure, LDL cholesterol, triglycerides), 2) exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure [NYHA classification], and angina pectoris [CCS classification]) and 3) subjective health (IRES-24: pain, somatic health, psychological wellbeing and depression as well as anxiety on the HADS). The study was prospective; data of patients were assessed at entry and discharge of rehabilitation. To measure the success of rehabilitation each parameter was graded in severity classes at entry and discharge. For each of the 13 quality indicators changes of severity class were rated in a rating matrix. For indicators without a requirement for medical care neither at entry nor at discharge no rating was performed.
Results: The grading into severity classes as well as the minimal important differences were given for the 13 quality indicators. The result of rehabilitation can be demonstrated in suitable form by means of rating of the 13 quality indicators according to a clinical population. The rating model differs well between clinically changed and unchanged patients for the quality indicators.
Conclusion: The result of cardiac rehabilitation can be assessed with 13 quality indicators measured at entry and discharge of the rehabilitation program. If a change into a more favorable category at the end of rehabilitation could be achieved it was counted as a success. The 13 quality indicators can be used to assess the individual result as well as the result of a population - e.g. all patients of a clinic in a specific time period. In addition, the assessment and rating of relevant quality indicators can be used for comparisons of rehabilitation centers.
Since the beginning of the 1970s a lot of countries in Latin America has been starting the transition to democracy. The article analyses the role played by the military in this process, especially the effects of civildemocratic governments – sometimes failing in – gaining power over the military. It is described how and why the army occasionally kept their independence from the civil power and how this influenced the consolidation of democracy.
I. Gründung, Aufgaben und Struktur des Hochkommissariats
II. Zur Rolle des OHCHR im und gegenüber dem Menschenrechtsrat
III. Zu Erfolgschancen von Feldmissionen in eher schwierigen Ländern: China, Russische Föderation, Afghanistan, Sudan und Kolumbien
IV. Zur Frage der politischen Unabhängigkeit des OHCHR
V. Schlussfolgerungen und Ausblick
Die zwölfte Konferenz des Forschungskreises Vereinte Nationen wurde am 28. Juni 2014 an der Universität Potsdam veranstaltet und stand unter dem Thema „Konzepte für die Reform der Vereinten Nationen“. Dabei wurde das komplexe Verhältnis zwischen Reformnotwendigkeit und Machbarkeitserwartungen einerseits und ausgebliebenen weitreichenden Strukturreformen und erfolgten „kleineren“, pragmatischen Reformschritten andererseits deutlich. Mit den vier Referaten stellte die Konferenz in der Tradition der Potsdamer UNO-Konferenzen die Verbindung von Wissenschaft und Praxis unter Beteiligung unterschiedlicher Disziplinen her.
Mit der Broschüre soll allen Interessierten die Möglichkeit gegeben werden, Einblick in ausgewählte Schwerpunkte der Reformdiskussion zu erhalten:
An ein Grundsatzreferat zu bisherigen Reformprozessen im UN-System insgesamt schließen sich drei Texte an, die das Verhältnis zwischen den Vereinten Nationen und den nichtstaatlichen Akteuren in den Blick nehmen, die relativ neue Institution des Menschenrechtsrates als Teil der Reformbemühungen betrachten und schließlich Ergebnisse und Trends bei den Reformen der Arbeitsmethoden des Sicherheitsrates erörtern.
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Menschenrechtliche Anforderungen an In-absentia-Verfahren
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