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Linnemann A, Hilsenbek MM, Lelieveld I, Geschke K, Wolf D, Fellgiebel A. Comparison of psychosocial and medical characteristics of patients with dementia and their primary informal caregivers between inpatient and day clinic treatment. DEMENTIA 2018; 19:606-617. [PMID: 29886778 DOI: 10.1177/1471301218781130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Caregiver burden is one of the most common reasons for hospitalization of patients with dementia. However, changes of location are not recommended for patients with dementia and associated with negative outcomes for patients with dementia. As there is yet a lack of outpatient treatment options, this study explores psychiatric day clinic treatment as option for patients with dementia by comparing characteristics of voluntarily treated patients with dementia and their respective informal caregivers between an inpatient and day clinic setting. Methods A total of 92 patients with dementia (56 inpatient, 36 day clinic) and their informal caregiver provided information on psychosocial and clinical characteristics (Mini-Mental-Status-Test, Neuropsychiatric Inventory, Bayer Activities of Daily Living, Barthel Index, Geriatric Depression Scale-30, Beck’s Depression Inventory-II, caregiver burden, Short Form Health Survey-36) at the beginning of treatment and at follow-up (n = 48 patient caregiver dyads) six months after discharge. Results Patients with dementia did not differ in disease severity, neuropsychiatric symptoms, and depression depending on treatment setting. However, the higher the Bayer activities of daily living score, the more likely treatment in day clinic was. Caregivers from patients with dementia in the inpatient setting were younger and reported more financial burden, whereas caregivers from patients with dementia in the day clinic reported lower physical health and more burden due to practical caring responsibilities. Longitudinal data indicated no differences in characteristics of patients with dementia and caregivers depending on treatment setting, despite caregivers from patients in the day clinic reporting more depressive symptoms after six months. Conclusion Day clinic treatment for voluntarily treated patients with dementia might be an alternative to inpatient settings. Patients with dementia do not substantially differ depending on treatment setting, rather characteristics of the caregivers were associated with placement in inpatient or day clinic setting. The needs of caregivers deserve special attention when considering treatment for patients with dementia.
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Affiliation(s)
- Alexandra Linnemann
- Rheinhessen-Fachklinik Alzey, Germany.,University Medical Hospital Mainz, Germany.,Rheinhessen-Fachklinik Alzey, Germany.,University Medical Hospital Mainz, Germany
| | | | - Irene Lelieveld
- Rheinhessen-Fachklinik Alzey, Germany.,University Medical Hospital Mainz, Germany
| | - Katharina Geschke
- Rheinhessen-Fachklinik Alzey, Germany.,University Medical Hospital Mainz, Germany
| | - Dominik Wolf
- University Medical Center Mainz, Mainz, Germany.,Rheinhessen-Fachklinik Alzey, Germany.,University Medical Hospital Mainz, Germany
| | - Andreas Fellgiebel
- Rheinhessen-Fachklinik Alzey, Germany.,University Medical Hospital Mainz, Germany
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102
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Penz M, Wekenborg MK, Pieper L, Beesdo-Baum K, Walther A, Miller R, Stalder T, Kirschbaum C. The Dresden Burnout Study: Protocol of a prospective cohort study for the bio-psychological investigation of burnout. Int J Methods Psychiatr Res 2018; 27:e1613. [PMID: 29611872 PMCID: PMC6877172 DOI: 10.1002/mpr.1613] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/21/2017] [Accepted: 01/23/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The Dresden Burnout Study (DBS) is a 12-year longitudinal cohort study that aims to provide a description of the burnout syndrome on the basis of time and symptom criteria with a special focus on the search for biomarkers. Biological and psychosocial approaches are applied to examine the long-term course and consequences of burnout within a population-based German-speaking sample aged 18 to 68 years. METHODS Demographics and psychosocial data are generated by online assessments, including demographics and questionnaires on burnout, burnout-related constructs, work-environment, and health-related factors. The lab-based biomarker assessment includes endocrine, physiological, immunological, and epigenetic markers obtained from blood and hair samples. In addition, heart rate variability is also measured repeatedly. Within the first 2 years, the DBS collected psychosocial data from over 7,600 participants with biological data obtained from more than 800 individuals. During the following 10 years, detailed assessments of biomarkers and psychosocial factors will be collected in annual study waves. RESULTS Results will be generated during the following decade. CONCLUSION The findings of the DBS are expected to pave the road for an in-depth biopsychosocial characterization of burnout and to give insight into the long-term course and potential mental and physical health consequences of the burnout syndrome.
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Affiliation(s)
- Marlene Penz
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Magdalena K Wekenborg
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Andreas Walther
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Robert Miller
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Tobias Stalder
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany.,Clinical Psychology, University of Siegen, Siegen, Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
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103
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Mindfulness vs psychoeducation in adult ADHD: a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2018; 268:321-335. [PMID: 29356899 DOI: 10.1007/s00406-018-0868-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 01/15/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Mindfulness training is a promising treatment approach in adult ADHD. However, there has not yet been a randomized controlled trial comparing mindfulness to an active control condition. In this study, we assessed the efficacy of a mindfulness training program (MAP) compared to structured psychoeducation (PE). METHODS After randomization 81 medication-free adult ADHD patients participated either in an 8-week MAP or PE group program. At baseline (T1), after 8 weeks (T2) and after 8 months (T3), severity of ADHD and associated symptoms (depression, general psychopathology, quality of life) were measured with the Conner's ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Brief Symptom Inventory (BSI) and the SF-36 by self and blind observer ratings. RESULTS Both groups showed significant pre-post improvements in observer-rated Inattention scale (p < .001, partial η2 = 0.18) and in associated symptomatology, which persisted through 6 months of follow-up. There were no significant differences regarding symptom reduction between the treatment groups. Women benefited more compared to men irrespective of treatment group. Men showed the most pronounced changes under MAP. CONCLUSIONS In the current study, MAP was not superior to PE regarding symptom reduction in adult ADHD. Both interventions, mindfulness meditation and PE, were efficacious in reducing symptom load in adult ADHD. Furthermore in exploratory post hoc tests the study provides evidence for a potential gender-specific treatment response in adult ADHD.
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104
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Sperlich B, Hahn LS, Edel A, Behr T, Helmprobst J, Leppich R, Wallmann-Sperlich B, Holmberg HC. A 4-Week Intervention Involving Mobile-Based Daily 6-Minute Micro-Sessions of Functional High-Intensity Circuit Training Improves Strength and Quality of Life, but Not Cardio-Respiratory Fitness of Young Untrained Adults. Front Physiol 2018; 9:423. [PMID: 29867519 PMCID: PMC5954292 DOI: 10.3389/fphys.2018.00423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/04/2018] [Indexed: 11/13/2022] Open
Abstract
The present study was designed to assess the psycho-physiological responses of physically untrained individuals to mobile-based multi-stimulating, circuit-like, multiple-joint conditioning (CircuitHIIT) performed either once (1xCircuitHIIT) or twice (2xCircuitHIIT) daily for 4 weeks. In this single-center, two-arm randomized, controlled study, 24 men and women (age: 25 ± 5 years) first received no training instructions for 4 weeks and then performed 4 weeks of either 1xCircuitHIIT or 2xCircuitHIIT (5 men and 7 women in each group) daily. The 1xCircuitHIIT and 2xCircuitHIIT participants carried out 90.7 and 85.7% of all planned training sessions, respectively, with average heart rates during the 6-min sessions of 74.3 and 70.8% of maximal heart rate. Body, fat and fat-free mass, and metabolic rate at rest did not differ between the groups or between time-points of measurement. Heart rate while running at 6 km⋅h-1 declined after the intervention in both groups. Submaximal and peak oxygen uptake, the respiratory exchange ratio and heart rate recovery were not altered by either intervention. The maximal numbers of push-ups, leg-levers, burpees, 45°-one-legged squats and 30-s skipping, as well as perception of general health improved in both groups. Our 1xCircuitHIIT or 2xCircuitHIIT interventions improved certain parameters of functional strength and certain dimensions of quality of life in young untrained individuals. However, they were not sufficient to enhance cardio-respiratory fitness, in particular peak oxygen uptake.
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Affiliation(s)
- Billy Sperlich
- Integrative and Experimental Exercise Science and Training, Institute for Sport Sciences, University of Würzburg, Würzburg, Germany
| | - Lea-Sofie Hahn
- Integrative and Experimental Exercise Science and Training, Institute for Sport Sciences, University of Würzburg, Würzburg, Germany
| | - Antonia Edel
- Integrative and Experimental Exercise Science and Training, Institute for Sport Sciences, University of Würzburg, Würzburg, Germany
| | - Tino Behr
- Integrative and Experimental Exercise Science and Training, Institute for Sport Sciences, University of Würzburg, Würzburg, Germany
| | - Julian Helmprobst
- Integrative and Experimental Exercise Science and Training, Institute for Sport Sciences, University of Würzburg, Würzburg, Germany
| | - Robert Leppich
- Integrative and Experimental Exercise Science and Training, Institute for Sport Sciences, University of Würzburg, Würzburg, Germany
| | | | - Hans-Christer Holmberg
- The Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden.,School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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105
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Dietrich C, Nehrdich S, Seifert S, Blume KR, Miltner WHR, Hofmann GO, Weiss T. Leg Prosthesis With Somatosensory Feedback Reduces Phantom Limb Pain and Increases Functionality. Front Neurol 2018; 9:270. [PMID: 29755399 PMCID: PMC5932153 DOI: 10.3389/fneur.2018.00270] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/06/2018] [Indexed: 01/18/2023] Open
Abstract
Phantom limb pain (PLP) develops in most patients with lower limb amputation. Changes in the peripheral and central nervous system (CNS) are hypothesized to contribute to PLP. Based on ideas to modify neural reorganization within the CNS, the aim of the study was to test, whether prostheses with somatosensory feedback might help to reduce PLP, and increase the functionality of movement with a prosthesis. We therefore equipped the prostheses of 14 lower leg amputees with a simple to use feedback system that provides electrocutaneous feedback to patients' thigh whenever the foot and toes of the prosthesis touch the ground. Two weeks of training with such a feedback prosthesis reduced PLP, increased the functional use of the prosthesis, and increased patients' satisfaction with prosthesis use. We found a significant overall reduction of PLP during the course of the training period. Most patients reported lower PLP intensities at the end of the day while before training they have usually experienced maximal PLP intensities. Furthermore, patients also reported larger walking distances and more stable walking and better posture control while walking on and across a bumpy or soft ground. After training, the majority of participants (9/14) preferred such a feedback system over no feedback. This study extends former observations of a similar training procedure with arm amputees who used a similar feedback training to improve the functionality of an arm prosthesis in manipulating and grasping objects.
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Affiliation(s)
- Caroline Dietrich
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Sandra Nehrdich
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Sandra Seifert
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Kathrin R. Blume
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | | | - Gunther O. Hofmann
- Berufsgenossenschaftliche Kliniken Bergmannstrost Halle/Saale, Halle, Germany
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany
| | - Thomas Weiss
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
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106
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König J, Block A, Becker M, Fenske K, Hertel J, Van der Auwera S, Zymara K, Völzke H, Freyberger HJ, Grabe HJ. Assessment of subjective emotional valence and long-lasting impact of life events: development and psychometrics of the Stralsund Life Event List (SEL). BMC Psychiatry 2018; 18:105. [PMID: 29669535 PMCID: PMC5907180 DOI: 10.1186/s12888-018-1649-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 03/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Life events (LEs) are associated with future physical and mental health. They are crucial for understanding the pathways to mental disorders as well as the interactions with biological parameters. However, deeper insight is needed into the complex interplay between the type of LE, its subjective evaluation and accompanying factors such as social support. The "Stralsund Life Event List" (SEL) was developed to facilitate this research. METHODS The SEL is a standardized interview that assesses the time of occurrence and frequency of 81 LEs, their subjective emotional valence, the perceived social support during the LE experience and the impact of past LEs on present life. Data from 2265 subjects from the general population-based cohort study "Study of Health in Pomerania" (SHIP) were analysed. Based on the mean emotional valence ratings of the whole sample, LEs were categorized as "positive" or "negative". For verification, the SEL was related to lifetime major depressive disorder (MDD; Munich Composite International Diagnostic Interview), childhood trauma (Childhood Trauma Questionnaire), resilience (Resilience Scale) and subjective health (SF-12 Health Survey). RESULTS The report of lifetime MDD was associated with more negative emotional valence ratings of negative LEs (OR = 2.96, p < 0.0001). Negative LEs (b = 0.071, p < 0.0001, β = 0.25) and more negative emotional valence ratings of positive LEs (b = 3.74, p < 0.0001, β = 0.11) were positively associated with childhood trauma. In contrast, more positive emotional valence ratings of positive LEs were associated with higher resilience (b = - 7.05, p < 0.0001, β = 0.13), and a lower present impact of past negative LEs was associated with better subjective health (b = 2.79, p = 0.001, β = 0.05). The internal consistency of the generated scores varied considerably, but the mean value was acceptable (averaged Cronbach's alpha > 0.75). CONCLUSIONS The SEL is a valid instrument that enables the analysis of the number and frequency of LEs, their emotional valence, perceived social support and current impact on life on a global score and on an individual item level. Thus, we can recommend its use in research settings that require the assessment and analysis of the relationship between the occurrence and subjective evaluation of LEs as well as the complex balance between distressing and stabilizing life experiences.
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Affiliation(s)
- Johanna König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489, Greifswald, Germany.
| | - Andrea Block
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany ,0000 0001 0942 1117grid.11348.3fDepartment of Health Sciences, Institute of Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Mathias Becker
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany ,Department of Psychiatry and Psychotherapy, Helios Clinic, Stralsund, Germany
| | - Kristin Fenske
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Johannes Hertel
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Sandra Van der Auwera
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany ,German Centre of Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Kathleen Zymara
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Henry Völzke
- grid.5603.0Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Harald Jürgen Freyberger
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany ,Department of Psychiatry and Psychotherapy, Helios Clinic, Stralsund, Germany
| | - Hans Jörgen Grabe
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany ,German Centre of Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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Hoffmann R, Große J, Nagl M, Niederwieser D, Mehnert A, Kersting A. Internet-based grief therapy for bereaved individuals after loss due to Haematological cancer: study protocol of a randomized controlled trial. BMC Psychiatry 2018; 18:52. [PMID: 29482525 PMCID: PMC5827988 DOI: 10.1186/s12888-018-1633-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/12/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Approximately 10% of the individuals experiencing the death of a loved one develop prolonged grief disorder (PGD) after bereavement. Family members of haematological cancer patients might be particularly burdened since their loss experience is preceded by a very strenuous time of disease and aggressive treatment. However, support needs of relatives of cancer patients often remain unmet, also after the death of the patient. Therapeutic possibilities are enhanced by providing easily available and accessible Internet-based therapies. This study will adapt and evaluate an Internet-based grief therapy for bereaved individuals after the loss of a significant other due to haematological cancer. METHODS The efficacy of the Internet-based grief therapy is evaluated in a randomized controlled trial with a wait-list control group. Inclusion criteria are bereavement due to hematological cancer and meeting the diagnostic criteria for PGD. Exclusion criteria are severe depression, suicidality, dissociative tendency, psychosis, posttraumatic stress disorder, substance use disorder, and current psychotherapeutic or psychopharmacological treatment. The main outcome is PGD severity. Secondary outcomes are depression, anxiety, somatization, posttraumatic stress, quality of life, sleep quality, and posttraumatic growth. Data is collected pre- and posttreatment. Follow-up assessments will be conducted 3, 6, and 12 months after completion of the intervention. The Internet-based grief therapy is assumed to have at least moderate effects regarding PGD and other bereavement-related mental health outcomes. Predictors and moderators of the treatment outcome and PGD will be determined. DISCUSSION Individuals bereaved due to haematological cancer are at high risk for psychological distress. Tailored treatment for this particularly burdened target group is missing. Our study results will contribute to a closing of this healthcare gap. TRIAL REGISTRATION German Clinical Trial Register UTN: U1111-1186-6255 . Registered 1 December 2016.
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Affiliation(s)
- Rahel Hoffmann
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Julia Große
- 0000 0001 2230 9752grid.9647.cDepartment of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Michaela Nagl
- 0000 0001 2230 9752grid.9647.cDepartment of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Dietger Niederwieser
- 0000 0001 2230 9752grid.9647.cDivision of Haematology and Medical Oncology, University of Leipzig, Johannisallee 32A, 04103 Leipzig, Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Anette Kersting
- 0000 0001 2230 9752grid.9647.cDepartment of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
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108
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Kraus EM, Rommel N, Stoll LH, Oettinger A, Vogel AP, Synofzik M. Validation and Psychometric Properties of the German Version of the SWAL-QOL. Dysphagia 2018; 33:431-440. [DOI: 10.1007/s00455-017-9872-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022]
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109
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Kerschbaum M, Hausmann N, Worlicek M, Pfeifer C, Nerlich M, Schmitz P. Patient-related outcome of unstable pelvic ring fractures stabilized with a minimal invasive screw-rod system. Health Qual Life Outcomes 2017; 15:248. [PMID: 29273093 PMCID: PMC5741929 DOI: 10.1186/s12955-017-0821-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 12/05/2017] [Indexed: 12/18/2022] Open
Abstract
Background Clinical and radiological outcomes of operatively treated unstable pelvic ring fractures are well documented, whereas little is known about the patient’s related outcome. The purpose of this study is to evaluate the patient-reported outcome after minimal invasive treatment of pelvic ring fractures using the SF-36 and EQ-5D medical outcome scores. Methods Patients with unstable pelvic ring fractures treated in our trauma department with a minimal invasive screw-rod system between 01/2004 and 12/2014 were included. Next to patient data (sex, age), injury related details (fracture type, additional injuries, Injury Severity Score (ISS)) as well as operation details (method, time to operation, general complications, adverse events associated with the surgical procedure, revision surgery, fracture reduction) were assessed. The patient related outcome was evaluated using the SF-36 and the EQ-5D score. Results A total of 105 patients (57 men; 48 women; mean age 56 ± 21 years) were identified as candidates for the study. 60 patients completed the SF-36 and EQ-5D score after a mean follow-up of five years (60.5 months (14-142 months)). Of these patients 77% were multiply injured with a mean ISS of 26 ± 19. Within the respondent group 22% showed type B and 78% type C pelvic ring fractures. In 82% the dorsal pelvic ring fracture was stabilized using a minimally invasive transiliac internal fixator, in 18% an iliolumbar fixation was performed respectively. The mean physical component score of the SF-36 was 37.9 ± 12.0, the mean mental component score was 49.8 ± 12.5. The mean EQ-5D VAS reached 70.5 ± 24.4. Conclusion Patients being multiply injured and treated with minimal invasive treated dorsal pelvic ring fractures were suffering more especially concerning physical domains compared to the healthy reference population. Nevertheless, the overall patient-related outcome is comparable to pelvic ring fractures in general. Trial Registration Number Clinical Trial Registry University of Regensburg Z-2017-0878-3. Registered 22. July 2017. Retrospectively registered.
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Affiliation(s)
- Maximilian Kerschbaum
- Clinic of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany
| | - Nadine Hausmann
- Clinic of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany
| | - Michael Worlicek
- Clinic of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany
| | - Christian Pfeifer
- Clinic of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany
| | - Michael Nerlich
- Clinic of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany
| | - Paul Schmitz
- Clinic of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
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Altmeier D, Kempe M, Memmert D. Stair self-efficacy questionnaire to test the ability of stair negotiation for older people. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2017. [DOI: 10.1007/s12662-017-0483-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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111
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Schaller A, Petrowski K, Pfoertner TK, Froboese I. Effectiveness of a theory-based multicomponent intervention (Movement Coaching) on the promotion of total and domain-specific physical activity: a randomised controlled trial in low back pain patients. BMC Musculoskelet Disord 2017; 18:431. [PMID: 29110703 PMCID: PMC5674836 DOI: 10.1186/s12891-017-1788-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/25/2017] [Indexed: 11/22/2022] Open
Abstract
Background The promotion of physical activity is a major field in rehabilitation and health promotion but evidence is lacking on what method or strategy works best. Ensuing from this research gap, the present study compared the effectiveness of a comprehensive theory based multicomponent intervention (Movement Coaching) to a low intensity intervention in low back pain patients. Methods A monocenter randomized controlled trial with three measuring points (T0 = baseline, T1 = six month follow-up, T2 = twelve month follow-up) was conducted. N = 412 chronic low back pain patients participated. The Movement Coaching group (n = 201) received a comprehensive multicomponent intervention with small-group intervention, phone- and web 2.0-intervention. The low intensity control (n = 211) received two oral presentations that were available for download afterwards. Main outcome was total physical activity measured by Global Physical Activity Questionnaire at 12 month follow-up. Additionally, workplace, leisure time and transportation activities were compared. A split-plot anova was conducted for evaluating repeated measure effects and between group effects. Results At six and twelve month follow-up there were no statistically significant between group differences in total (T1: p = 0.79; T2: p = 0.30) as well as domain-specific physical activity (workplace (T1: p = 0.16; T2: p = 0.65), leisure time (T1: p = 0.54; T2: p = 0.89), transportation (T1: p = 0.29; T2: p = 0.77) between Movement Coaching and the control group. In both groups, workplace physical activity showed the highest proportion of total physical activity. From baseline to twelve month follow-up the results showed a decline in total physical activity (Movement Coaching: p = 0.04; control group: p = 0.50). Conclusions The comprehensive Movement Coaching intervention was not found to be more effective than a low intensity intervention in promoting total and domain-specific physical activity in chronic low back pain patients. Trial registration This study is registered at German Clinical Trials Register (DRKS)-ID: DRKS00004878.
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Affiliation(s)
- Andrea Schaller
- IST-Hochschule University of Applied Sciences, Erkrather Str. 220 a-c, 40233, Düsseldorf, Germany. .,Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
| | - Katja Petrowski
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Timo-Kolja Pfoertner
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, 50933, Cologne, Germany
| | - Ingo Froboese
- Center for Health through Sport and Movement, German Sport University Cologne, 50933, Cologne, Germany
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Neuropsychological Outcome following Resuscitation after Out-of-Hospital Cardiac Arrest: A One-Year Follow-Up. Case Rep Cardiol 2017; 2017:7283606. [PMID: 28845315 PMCID: PMC5563396 DOI: 10.1155/2017/7283606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/19/2017] [Accepted: 07/03/2017] [Indexed: 11/18/2022] Open
Abstract
A 61-year-old woman survived resuscitation after out-of-hospital cardiac arrest. The heterogeneity of the resulting cognitive impairments and the recovery over a one-year period are presented, highlighting the need for standardized neuropsychological testing even after short cardiac arrests and for effective treatment both out of hospital and in hospital.
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113
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Noser E, Walther A, Ehlert U. Are Psychosocial Resources Associated With Perceived Facial Aging in Men? Gerontol Geriatr Med 2017; 3:2333721417714875. [PMID: 28660241 PMCID: PMC5476325 DOI: 10.1177/2333721417714875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/16/2017] [Accepted: 05/18/2017] [Indexed: 11/24/2022] Open
Abstract
Background: Looking younger than actual age has been related to a variety of health outcomes. Optimism, self-esteem, and relationship satisfaction are important psychosocial resources for mental health. Little is known about their relation with a younger facial appearance. Objective: This study analyzed whether these psychosocial resources are associated with a younger facial appearance and if their effects were mediated through mental health. Method: A sample of N = 223 self-reporting healthy men aged 40 to 75 years filled in questionnaires to assess optimism (Life Orientation Test–Revised), self-esteem (Multidimensional Self-Esteem Scale), relationship satisfaction (Relationship Assessment Scale), and mental health (Short-Form Health Survey). Five female raters estimated the visual age of each participant from a frontal face photograph. Results: Looking younger (compared with chronological age) was correlated with optimism, relationship satisfaction, and mental health. Mediation analyses and structural equation modeling indicated that mental health mediated the association between each psychosocial resource and a younger appearance. Discussion: The results emphasize the importance of promoting psychosocial resources and mental health in men 40+ for the maintenance of good health and the deceleration of facial aging.
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Affiliation(s)
- Emilou Noser
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program, Dynamics of Healthy Aging, University of Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program, Dynamics of Healthy Aging, University of Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program, Dynamics of Healthy Aging, University of Zurich, Switzerland
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114
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Hassel JC, Jiang H, Bender C, Winkler J, Sevko A, Shevchenko I, Halama N, Dimitrakopoulou-Strauss A, Haefeli WE, Jäger D, Enk A, Utikal J, Umansky V. Tadalafil has biologic activity in human melanoma. Results of a pilot trial with Tadalafil in patients with metastatic Melanoma (TaMe). Oncoimmunology 2017; 6:e1326440. [PMID: 28932631 PMCID: PMC5599085 DOI: 10.1080/2162402x.2017.1326440] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/27/2017] [Accepted: 04/29/2017] [Indexed: 01/01/2023] Open
Abstract
Myeloid-derived suppressor cells (MDSCs) are known to play a critical role in the suppression of T cell antitumor responses. Our preclinical data showed that the phosphodiesterase (PDE)-5 inhibitor sildenafil impaired MDSC functions, enhanced intratumoral T cell activity and prolonged survival of melanoma-bearing mice. In this study, we evaluated biologic effects, safety and efficacy of palliative treatment with the PDE-5 inhibitor tadalafil in metastatic melanoma patients. We conducted an open-label, dose de-escalation trial with tadalafil in pretreated metastatic melanoma patients. Tumor and peripheral blood samples were taken before and 4 weeks after the start of treatment. Samples were investigated by immunohistochemistry and FACS analysis, for different immune subsets with numbers of CD8+ tumor-infiltrating lymphocytes (TIL) as primary end point. Stable disease was achieved in 3/12 patients (25%). Median progression-free survival was 4.6 mo (range 0.7–7.1), median overall survival (OS) 8.5 mo (range 2.7–23.7). The treatment was well tolerated. Stable patients displayed significantly higher numbers of CD8+ TIL in the center of metastases before treatment as compared with progressive patients. Upon the therapy, they showed increased expression of ζ-chain (used as a marker of T cell activation) in CD8+ and CD4+TILs and CD8+T cells in the peripheral blood as compared with baseline. Our study suggests that the PDE-5 inhibitor tadalafil can improve clinical outcome of advanced melanoma patients by enhancing antitumor immunity and highlights its potential application in combined melanoma immunotherapy.
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Affiliation(s)
- Jessica C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Huanhuan Jiang
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Heidelberg, Germany.,Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The First Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Carolin Bender
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Winkler
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexandra Sevko
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Heidelberg, Germany
| | - Ivan Shevchenko
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Heidelberg, Germany
| | - Niels Halama
- Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Antonia Dimitrakopoulou-Strauss
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ) and University Hospital Heidelberg, Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Enk
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Jochen Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Heidelberg, Germany
| | - Viktor Umansky
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Heidelberg, Germany
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115
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Schunk M, Reitmeir P, Rückert-Eheberg IM, Tamayo T, Schipf S, Meisinger C, Peters A, Scheidt-Nave C, Ellert U, Hartwig S, Kluttig A, Völzke H, Holle R. Longitudinal change in health-related quality of life in people with prevalent and incident type 2 diabetes compared to diabetes-free controls. PLoS One 2017; 12:e0176895. [PMID: 28467489 PMCID: PMC5415190 DOI: 10.1371/journal.pone.0176895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/24/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The objective of this analysis is to compare people with prevalent type 2 diabetes, incident type 2 diabetes and without diabetes with respect to longitudinal change in health-related quality of life (HRQOL) when adjusting for baseline determinants of HRQOL. RESEARCH DESIGN AND METHODS Primary baseline and follow-up data from three regional and one national population-based cohort studies in Germany were pooled for analysis. HRQOL was measured using physical and mental health summary scores (PCS and MCS) from the German version of the Short Form Health Survey with 36 or 12 items. Mean score change per observation year was compared between the three groups (prevalent diabetes, incident diabetes, no diabetes) based on linear regression models. RESULTS The analysis included pooled data from 5367 people aged 45-74 years at baseline. Of these, 85.5% reported no diabetes at baseline and follow-up, 6.3% reported diabetes at both baseline and follow-up (prevalent diabetes), and 8.2% reported diabetes only at follow-up (incident diabetes). Over a mean observation period of 8.7 years, annual decline in HRQOL scores is pronounced at 0.27-0.32 (PCS) and 0.34-0.38 (MCS) in the group with prevalent diabetes compared with people without diabetes. Those with incident diabetes showed intermediate values but did not differ significantly from people without diabetes after adjustment for covariates in the full model. CONCLUSION Compared with data from cross-sectional analysis, the HRQOL loss associated with prevalent diabetes appears to be much larger than previously assumed.
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Affiliation(s)
- Michaela Schunk
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Partner Site Helmholtz Zentrum München, Germany
| | - Peter Reitmeir
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Partner Site Helmholtz Zentrum München, Germany
| | - Ina-Maria Rückert-Eheberg
- German Center for Diabetes Research (DZD), Partner Site Helmholtz Zentrum München, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Neuherberg, Germany
| | - Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Site DDZ Düsseldorf, Germany
| | - Sabine Schipf
- Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany
- German Center for Diabetes Research (DZD), Project Partner Site Uni Greifswald, Greifswald, Germany
| | - Christa Meisinger
- German Center for Diabetes Research (DZD), Partner Site Helmholtz Zentrum München, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD), Partner Site Helmholtz Zentrum München, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Neuherberg, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert-Koch-Institute, Berlin, Germany
- German Center for Diabetes Research (DZD), Project Partner Site RKI, Berlin, Germany
| | - Ute Ellert
- Department of Epidemiology and Health Monitoring, Robert-Koch-Institute, Berlin, Germany
- German Center for Diabetes Research (DZD), Project Partner Site RKI, Berlin, Germany
| | - Saskia Hartwig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Diabetes Research (DZD), Project Partner Site Uni Halle-Wittenberg, Halle, Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Diabetes Research (DZD), Project Partner Site Uni Halle-Wittenberg, Halle, Germany
| | - Henry Völzke
- Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany
- German Center for Diabetes Research (DZD), Project Partner Site Uni Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research, Partner Site Greifswald, Germany
| | - Rolf Holle
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Partner Site Helmholtz Zentrum München, Germany
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116
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Akmatov MK, Riese P, May M, Jentsch L, Ahmed MW, Werner D, Rösel A, Tyler M, Pessler K, Prokein J, Bernemann I, Klopp N, Prochnow B, Trittel S, Tallam A, Illig T, Schindler C, Guzmán CA, Pessler F. Establishment of a cohort for deep phenotyping of the immune response to influenza vaccination among elderly individuals recruited from the general population. Hum Vaccin Immunother 2017; 13:1630-1639. [PMID: 28394705 DOI: 10.1080/21645515.2017.1299300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Elderly individuals have the highest burden of disease from influenza infection but also the lowest immune response to influenza vaccination. A better understanding of the host response to influenza vaccination in the elderly is therefore urgently needed. We conducted a biphasic prospective, population-based study from Dec. 2014 to May 2015 (pilot study) and Sept. 2015 to May 2016 (main study). Individuals 65-80 y of age were randomly selected from the residents' registration office in Hannover, Germany, for the pilot (n = 34) and main study (n = 200). The pilot study tested recruitment for study arms featuring 2, 4, or 5 visits/blood draws. The 5-visit (day 0, 1/3, 7, 21, 70 with respect to vaccination) study arm was selected for the main study. Both studies featured vaccination with Fluad™ (Novartis, Italy), a detailed medical history, a physical exam, recording of adverse events, completion of a questionnaire on common infections and an end-of-study questionnaire, and blood samples. Response rates in the pilot and main studies were 3.7% and 4.0%, respectively. Willingness to participate did not differ among the study arms (Fisher's exact test, p = 0.44). In both studies, there were no losses to follow-up. Compliance with study visits, blood sampling and completion of the questionnaires was very high (100%, >97%, 100%, respectively), as were participants' acceptance of and satisfaction with both phases of the study. The low response rates indicate the need for optimized recruitment strategies if the study population is to be representative of the general population. Nonetheless, the complex prospective study design proved to be highly feasible.
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Affiliation(s)
- Manas K Akmatov
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany.,b Helmholtz Centre for Infection Research , Braunschweig , Germany.,c Centre for Individualized Infection Medicine , Hannover , Germany
| | - Peggy Riese
- d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Marcus May
- e Clinical Research Center Hannover , Hannover Medical School , Hannover , Germany
| | - Leonhard Jentsch
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Malik W Ahmed
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Damaris Werner
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Anja Rösel
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Megan Tyler
- e Clinical Research Center Hannover , Hannover Medical School , Hannover , Germany
| | - Kevin Pessler
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Jana Prokein
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Inga Bernemann
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Norman Klopp
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Blair Prochnow
- d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Stephanie Trittel
- d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Aravind Tallam
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Thomas Illig
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Christoph Schindler
- e Clinical Research Center Hannover , Hannover Medical School , Hannover , Germany
| | - Carlos A Guzmán
- c Centre for Individualized Infection Medicine , Hannover , Germany.,d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Frank Pessler
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany.,b Helmholtz Centre for Infection Research , Braunschweig , Germany.,c Centre for Individualized Infection Medicine , Hannover , Germany
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117
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Sperlich B, Wallmann-Sperlich B, Zinner C, Von Stauffenberg V, Losert H, Holmberg HC. Functional High-Intensity Circuit Training Improves Body Composition, Peak Oxygen Uptake, Strength, and Alters Certain Dimensions of Quality of Life in Overweight Women. Front Physiol 2017; 8:172. [PMID: 28420999 PMCID: PMC5376588 DOI: 10.3389/fphys.2017.00172] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/07/2017] [Indexed: 12/29/2022] Open
Abstract
The effects of circuit-like functional high-intensity training (CircuitHIIT) alone or in combination with high-volume low-intensity exercise (Circuitcombined) on selected cardio-respiratory and metabolic parameters, body composition, functional strength and the quality of life of overweight women were compared. In this single-center, two-armed randomized, controlled study, overweight women performed 9-weeks (3 sessions·wk−1) of either CircuitHIIT (n = 11), or Circuitcombined (n = 8). Peak oxygen uptake and perception of physical pain were increased to a greater extent (p < 0.05) by CircuitHIIT, whereas Circuitcombined improved perception of general health more (p < 0.05). Both interventions lowered body mass, body-mass-index, waist-to-hip ratio, fat mass, and enhanced fat-free mass; decreased ratings of perceived exertion during submaximal treadmill running; improved the numbers of push-ups, burpees, one-legged squats, and 30-s skipping performed, as well as the height of counter-movement jumps; and improved physical and social functioning, role of physical limitations, vitality, role of emotional limitations, and mental health to a similar extent (all p < 0.05). Either forms of these multi-stimulating, circuit-like, multiple-joint training can be employed to improve body composition, selected variables of functional strength, and certain dimensions of quality of life in overweight women. However, CircuitHIIT improves peak oxygen uptake to a greater extent, but with more perception of pain, whereas Circuitcombined results in better perception of general health.
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Affiliation(s)
- Billy Sperlich
- Integrative and Experimental Exercise Science, Institute of Sport Science, University of WürzburgWürzburg, Germany
| | - Birgit Wallmann-Sperlich
- Institute of Sport Science, University of WürzburgWürzburg, Germany.,Institute of Health Promotion and Clinical Movement Science, German Sport University CologneCologne, Germany
| | - Christoph Zinner
- Integrative and Experimental Exercise Science, Institute of Sport Science, University of WürzburgWürzburg, Germany
| | - Valerie Von Stauffenberg
- Integrative and Experimental Exercise Science, Institute of Sport Science, University of WürzburgWürzburg, Germany
| | - Helena Losert
- Integrative and Experimental Exercise Science, Institute of Sport Science, University of WürzburgWürzburg, Germany
| | - Hans-Christer Holmberg
- School of Kinesiology, University of British ColumbiaVancouver, BC, Canada.,School of Sport Sciences, University of Tromsø-Arctic University of NorwayTromsø, Norway
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118
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Gieseler A, Tahden MAS, Thiel CM, Wagener KC, Meis M, Colonius H. Auditory and Non-Auditory Contributions for Unaided Speech Recognition in Noise as a Function of Hearing Aid Use. Front Psychol 2017; 8:219. [PMID: 28270784 PMCID: PMC5318449 DOI: 10.3389/fpsyg.2017.00219] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/06/2017] [Indexed: 11/13/2022] Open
Abstract
Differences in understanding speech in noise among hearing-impaired individuals cannot be explained entirely by hearing thresholds alone, suggesting the contribution of other factors beyond standard auditory ones as derived from the audiogram. This paper reports two analyses addressing individual differences in the explanation of unaided speech-in-noise performance among n = 438 elderly hearing-impaired listeners (mean = 71.1 ± 5.8 years). The main analysis was designed to identify clinically relevant auditory and non-auditory measures for speech-in-noise prediction using auditory (audiogram, categorical loudness scaling) and cognitive tests (verbal-intelligence test, screening test of dementia), as well as questionnaires assessing various self-reported measures (health status, socio-economic status, and subjective hearing problems). Using stepwise linear regression analysis, 62% of the variance in unaided speech-in-noise performance was explained, with measures Pure-tone average (PTA), Age, and Verbal intelligence emerging as the three most important predictors. In the complementary analysis, those individuals with the same hearing loss profile were separated into hearing aid users (HAU) and non-users (NU), and were then compared regarding potential differences in the test measures and in explaining unaided speech-in-noise recognition. The groupwise comparisons revealed significant differences in auditory measures and self-reported subjective hearing problems, while no differences in the cognitive domain were found. Furthermore, groupwise regression analyses revealed that Verbal intelligence had a predictive value in both groups, whereas Age and PTA only emerged significant in the group of hearing aid NU.
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Affiliation(s)
- Anja Gieseler
- Cluster of Excellence 'Hearing4all', University of OldenburgOldenburg, Germany; Cognitive Psychology Lab, Department of Psychology, University of OldenburgOldenburg, Germany
| | - Maike A S Tahden
- Cluster of Excellence 'Hearing4all', University of OldenburgOldenburg, Germany; Cognitive Psychology Lab, Department of Psychology, University of OldenburgOldenburg, Germany
| | - Christiane M Thiel
- Cluster of Excellence 'Hearing4all', University of OldenburgOldenburg, Germany; Biological Psychology Lab, Department of Psychology, University of OldenburgOldenburg, Germany
| | - Kirsten C Wagener
- Cluster of Excellence 'Hearing4all', University of OldenburgOldenburg, Germany; Hörzentrum Oldenburg GmbHOldenburg, Germany
| | - Markus Meis
- Cluster of Excellence 'Hearing4all', University of OldenburgOldenburg, Germany; Hörzentrum Oldenburg GmbHOldenburg, Germany
| | - Hans Colonius
- Cluster of Excellence 'Hearing4all', University of OldenburgOldenburg, Germany; Cognitive Psychology Lab, Department of Psychology, University of OldenburgOldenburg, Germany
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119
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Studerus-Germann AM, Engel DC, Stienen MN, von Ow D, Hildebrandt G, Gautschi OP. Three versus seven days to return-to-work after mild traumatic brain injury: a randomized parallel-group trial with neuropsychological assessment. Int J Neurosci 2017; 127:900-908. [PMID: 28042930 DOI: 10.1080/00207454.2017.1278589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although most patients with a mild traumatic brain injury (mTBI) recover within days to weeks, some experience persistent physical, cognitive and emotional symptoms, often described as post-concussion syndrome (PCS). The optimal recovery time including return-to-work (RTW) after mTBI is unclear. In this single-centre parallel-group trial, patients assigned three days (3D-group) or seven days (7D-group) sick leave were compared with a comprehensive neuropsychological test battery including the Post-Concussion Symptom Scale (PCSS) within one week, after three and 12 months post-injury. The influence of the effective time until RTW on post-concussional symptoms and cognitive performance was analysed. The 3D-group rated significantly higher mean scores in some PCSS symptoms, tended to fulfil diagnosis criteria of PCS more often and showed better cognitive performance in several neuropsychological test scores than the 7D-group at all three time-points of follow-up. Overall, patients returned to work 11.35 d post-injury, thus distinctly above both recommended sick leaves. There was a trend for longer sick leave in patients randomized into the 3D-group. Further analyses revealed that the group with an absolute RTW within one week showed lower symptom severity in fatigue at 3 and 12 months, less PCS and faster performance in fine motor speed at 12 months than the group with an absolute RTW after one week. Our data underline the heterogeneity of mTBI and show that acute and sub-acute symptoms are not prognostic factors for neuropsychological outcome at one year. Later, ability to work seems to be prognostic for long-term occurrence of PCS.
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Affiliation(s)
- Aline M Studerus-Germann
- a Division of Neuropsychology , Department of Neurology , State Hospital St. Gallen , St. Gallen , Switzerland.,b Department of Psychopathology and Clinical Intervention , University of Zurich , Zurich , Switzerland
| | - Doortje C Engel
- c Department of Neurosurgery , Cantonal Hospital St. Gallen , St. Gallen , Switzerland.,d Department of Neurosurgery , University Hospital Tübingen , Tübingen , Germany
| | - Martin N Stienen
- c Department of Neurosurgery , Cantonal Hospital St. Gallen , St. Gallen , Switzerland.,e Department of Neurosurgery and Faculty of Medicine , University Hospital Geneva , Geneva , Switzerland
| | - Dieter von Ow
- f Emergency Department , Cantonal Hospital St. Galllen , St. Gallen , Switzerland
| | - Gerhard Hildebrandt
- c Department of Neurosurgery , Cantonal Hospital St. Gallen , St. Gallen , Switzerland
| | - Oliver P Gautschi
- c Department of Neurosurgery , Cantonal Hospital St. Gallen , St. Gallen , Switzerland.,f Emergency Department , Cantonal Hospital St. Galllen , St. Gallen , Switzerland
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120
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Beller J, Wagner A. Disentangling Loneliness: Differential Effects of Subjective Loneliness, Network Quality, Network Size, and Living Alone on Physical, Mental, and Cognitive Health. J Aging Health 2017; 30:521-539. [PMID: 28553795 DOI: 10.1177/0898264316685843] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether different measures of social disconnectedness-subjective loneliness, network quality, network size, living alone-have differential effects on the health of older adults. METHODS We used a longitudinal sample of the German Aging Survey ( N = 4,184) and analyzed seven measures of health (life satisfaction, positive affect, negative affect, depression, cognitive performance, physical functioning, and pulmonary function) via regression analyses. RESULTS We found that subjective loneliness and network quality best predicted mental health; contrarily, network size and living alone best predicted physical and cognitive health. DISCUSSION Different measures of social disconnectedness have differential effects on health. Therefore, using only global measures or one aspect of social disconnectedness might obfuscate potential health hazards. Researchers and practitioners should be mindful of differences between these measures and should include multiple aspects of social disconnectedness in their research and practice. Future studies should explore the causes why these measures and their effects differ.
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121
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Böhmer MM, Brandl M, Brandstetter S, Finger T, Fischer W, Pfeifer M, Apfelbacher C. Factors associated with generic health-related quality of life in adult asthma patients in Germany: Cross-sectional study. J Asthma 2016; 54:325-334. [PMID: 27624747 DOI: 10.1080/02770903.2016.1206563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Given a 9% lifetime prevalence of asthma in Germany and the impairment of health-related quality of life (HRQOL) that goes along with it, it is important to understand parameters affecting HRQOL in asthma patients. Objective of this study was therefore to determine factors associated with generic HRQOL in asthma patients. METHODS Data for cross-sectional analyses were obtained from the baseline of an ongoing cohort study. INCLUSION CRITERIA physician-diagnosed asthma; age ≥18 years; disease duration ≥3 months; no acute psychiatric/neurological disease; sufficient knowledge of German. HRQOL was assessed by the Short Form 12 Health Survey Questionnaire (SF-12), which comprises a physical (PCS-12) and a mental component (MCS-12). Information on a broad range of parameters potentially influencing HRQOL was collected by examining the patients' medical records and via a self-administered questionnaire. Those parameters were of socio-demographic, disease-specific, treatment-related or psychosocial nature. We conducted multivariable linear regression analyses to assess determinants of HRQOL. RESULTS In total, 196 asthma patients participated in the study (mean age: 48 years (range: 18-90); 60.2% females). In multivariable analysis, PCS-12 was negatively associated with older age, being female, insufficient disease control, higher number of medications in tablet form and reporting symptoms of depression. MCS-12 was negatively associated with being female, living alone, insufficient disease control, and reporting symptoms of anxiety or depression. CONCLUSIONS Focusing on disease control and screening for depression and anxiety may be promising approaches to improve HRQOL in adult asthma patients. If a patient shows alarming symptoms of anxiety and/or depression, the patient should then be referred for psychiatric treatment.
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Affiliation(s)
- Merle M Böhmer
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Magdalena Brandl
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Susanne Brandstetter
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Tamara Finger
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Wiebke Fischer
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Michael Pfeifer
- b Department of Pneumology , Donaustauf Hospital , Donaustauf , Germany
| | - Christian Apfelbacher
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
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Tiede M, Dwinger S, Herbarth L, Härter M, Dirmaier J. Long-term effectiveness of telephone-based health coaching for heart failure patients: A post-only randomised controlled trial. J Telemed Telecare 2016; 23:716-724. [PMID: 27605214 DOI: 10.1177/1357633x16668436] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The * Equal contributors. health-status of heart failure patients can be improved to some extent by disease self-management. One method of developing such skills is telephone-based health coaching. However, the effects of telephone-based health coaching remain inconclusive. The aim of this study was to evaluate the effects of telephone-based health coaching for people with heart failure. Methods A total sample of 7186 patients with various chronic diseases was randomly assigned to either the coaching or the control group. Then 184 patients with heart failure were selected by International Classification of Diseases (ICD)-10 code for subgroup analysis. Data were collected at 24 and 48 months after the beginning of the coaching. The primary outcome was change in quality of life. Secondary outcomes were changes in depression and anxiety, health-related control beliefs, control preference, health risk behaviour and health-related behaviours. Statistical analyses included a per-protocol evaluation, employing analysis of variance and analysis of covariance (ANCOVA) as well as Mann-Whitney U tests. Results Participants' average age was 73 years (standard deviation (SD) = 9) and the majority were women (52.8%). In ANCOVA analyses there were no significant differences between groups for the change in quality of life (QoL). However, the coaching group reported a significantly higher level of physical activity ( p = 0.03), lower intake of non-prescribed drugs ( p = 0.04) and lower levels of stress ( p = 0.02) than the control group. Mann-Whitney U tests showed a different external locus of control ( p = 0.014), and higher reduction in unhealthy nutrition ( p = 0.019), physical inactivity ( p = 0.004) and stress ( p = 0.028). Discussion Our results suggest that telephone-based health coaching has no effect on QoL, anxiety and depression of heart failure patients, but helps in improving certain risk behaviours and changes the locus of control to be more externalised.
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Affiliation(s)
- Michel Tiede
- 1 Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany
| | - Sarah Dwinger
- 1 Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Martin Härter
- 1 Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany
| | - Jörg Dirmaier
- 1 Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany
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Schaller A, Dintsios CM, Icks A, Reibling N, Froboese I. Promoting physical activity in low back pain patients: six months follow-up of a randomised controlled trial comparing a multicomponent intervention with a low intensity intervention. Clin Rehabil 2016; 30:865-77. [PMID: 27496696 PMCID: PMC4976660 DOI: 10.1177/0269215515618730] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 11/01/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess a comprehensive multicomponent intervention against a low intensity intervention for promoting physical activity in chronic low back pain patients. DESIGN Randomised controlled trial. SETTING Inpatient rehabilitation and aftercare. SUBJECTS A total of 412 patients with chronic low back pain. INTERVENTIONS A multicomponent intervention (Movement Coaching) comprising of small group intervention (twice during inpatient rehabilitation), tailored telephone aftercare (twice after rehabilitation) and internet-based aftercare (web 2.0 platform) versus a low level intensity intervention (two general presentations on physical activity, download of the presentations). MAIN MEASURES Physical activity was measured using a questionnaire. Primary outcome was total physical activity; secondary outcomes were setting specific physical activity (transport, workplace, leisure time) and pain. Comparative group differences were evaluated six months after inpatient rehabilitation. RESULTS At six months follow-up, 92 participants in Movement Coaching (46 %) and 100 participants in the control group (47 %) completed the postal follow-up questionnaire. No significant differences between the two groups could be shown in total physical activity (P = 0.30). In addition to this, workplace (P = 0.53), transport (P = 0.68) and leisure time physical activity (P = 0.21) and pain (P = 0.43) did not differ significantly between the two groups. In both groups, physical activity decreased during the six months follow-up. CONCLUSIONS The multicomponent intervention was no more effective than the low intensity intervention in promoting physical activity at six months follow-up. The decrease in physical activity in both groups is an unexpected outcome of the study and indicates the need for further research.
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Affiliation(s)
- Andrea Schaller
- Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Cologne, Germany IST-University of Applied Sciences, Duesseldorf, Germany
| | | | - Andrea Icks
- IST-University of Applied Sciences, Duesseldorf, Germany
| | - Nadine Reibling
- Public Health Unit, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Düsseldorf, Germany
| | - Ingo Froboese
- Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Cologne, Germany
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Köpke S, Kasper J, Flachenecker P, Meißner H, Brandt A, Hauptmann B, Bender G, Backhus I, Rahn AC, Pöttgen J, Vettorazzi E, Heesen C. Patient education programme on immunotherapy in multiple sclerosis (PEPIMS): a controlled rater-blinded study. Clin Rehabil 2016; 31:250-261. [DOI: 10.1177/0269215516639734] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis. Design: Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts. Setting: Three neurological rehabilitation centres. Subjects: Patients with multiple sclerosis within rehabilitation. Interventions: Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure. Main measures: Primary endpoint was “informed choice”, comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, self-efficacy, and fatigue. Results: A total of 156 patients were included (IG=75, CG=81). The intervention led to significantly more participants with informed choice (IG: 47% vs. CG: 23%, P=0.004). The rate of persons with adequate risk knowledge was significantly higher in the IG two weeks after the intervention (IG: 54% vs. CG: 31%, P=0.007), but not after six months (IG: 48% vs. CG: 31%, P=0.058). No significant differences were shown for positive attitude towards disease modifying therapy (IG: 62% vs. CG: 71%, P=0.29) and for disease modifying therapy status after six months (IG: 61.5% vs CG: 68.6%, P=0.39). Also no differences were found for autonomy preferences and decisional conflict after six months. Conclusion: Delivering evidence-based information on multiple sclerosis disease modifying therapies within a rehabilitation setting led to a marked increase of informed choices.
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Affiliation(s)
- S Köpke
- Institute of Social Medicine, University of Lübeck, Lübeck, Germany
| | - J Kasper
- Department of Health and Caring Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - P Flachenecker
- Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany
| | - H Meißner
- Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany
| | - A Brandt
- Department of Neurology, Segeberger Kliniken, Bad Segeberg, Germany
| | - B Hauptmann
- Department of Neurology, Segeberger Kliniken, Bad Segeberg, Germany
- Department of Therapeutic Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - G Bender
- RehaCentre Hamburg, Hamburg, Germany
| | - I Backhus
- Unit of Health Sciences and Education, MIN Faculty, University of Hamburg, Hamburg, Germany
- Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - AC Rahn
- Unit of Health Sciences and Education, MIN Faculty, University of Hamburg, Hamburg, Germany
- Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Pöttgen
- Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Heesen
- Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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125
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[Well-being and psychosocial activities in nursing homes : Survey of residents]. Z Gerontol Geriatr 2016; 50:538-546. [PMID: 27351557 DOI: 10.1007/s00391-016-1080-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 04/13/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Assessment and self-assessment frequently differ, e. g. in psychosomatic disorders and complaints. At the same time the prevalence of corresponding disorders in old age is high. OBJECTIVE This study investigated psychosocial factors from the perspective of nursing home residents and compared this self-assessment with data collected in other scientific studies with assessments by nursing home staff. The aim was to develop specific recommendations for the nursing home sector. MATERIAL AND METHODS In this cross-sectional pilot study 256 nursing home residents (average age 81 ± 10.3 years, 69 % female, 31 % male) were questioned about their physical, psychological and social activities and well-being in semistructured anonymous interviews. Psychological screening tests were simultaneously implemented to assess symptoms of depression and dementia using the short form of the geriatric depression scale (GDS-K) and the mini mental status test (MMST). RESULTS The results showed that 44.6 % of the residents had symptoms of depression and 76.1 % revealed signs of development of dementia. More than half assessed their physical health as good to very good. According to comparable studies nursing staff assessed persistent pain in 20.7 % of all nursing home residents while personal interviews with the residents showed that persistent pain (39.8 %) was almost twice as frequent. Life satisfaction showed a significant correlation with the following items from the self-assessment: participation in nursing home activities (r = 0.171, p = 0.008), mobility (r = -0.131; p = 0.045), emotional activity (r = 0.136, p = 0.038), subjectively experienced physical health (r = -0.420, p < 0.001) and persistent pain (r = -0.178, p = 0.006). Life satisfaction correlated highly significantly with symptoms of depression (r = -0.617, p < 0.001) and cognitive performance (r = 0.251, p = 0.001). CONCLUSION The findings of this study encourage further research on the characteristic features of satisfied residents and (psycho)therapeutic support in order to promote factors for well-being and a positive quality of life in nursing homes.
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126
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Steinert A, Haesner M, Steinhagen-Thiessen E. [App-based self-monitoring in type 2 diabetes]. Z Gerontol Geriatr 2016; 50:516-523. [PMID: 27282168 DOI: 10.1007/s00391-016-1082-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/08/2016] [Accepted: 05/03/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The success of self-monitoring in the treatment of type 2 diabetes mellitus has already been verified in several studies. To date there are a multitude of smartphone apps which support diabetic patients in systematically recording and analyzing relevant health data; however, most of these smartphone apps are primarily developed for a young target group. OBJECTIVE As part of this study we examined to what extent a smartphone app for self-monitoring is used by older diabetic patients. METHODS In this study 36 adults with type 2 diabetes mellitus older than 60 years were included. After a comprehensive training course the participants used the application for 3 months. Reminders for medication, physical activity and diet could be set and recorded health data, such as weight or blood sugar, could be entered into the app. After 3 months the data were analyzed concerning usage behavior and impact on overall health. RESULTS Data analysis revealed intensive usage of the smartphone app (90 % on a daily basis). Furthermore, according to the patients, after the study period significant improvements in medication adherence and psychological well-being were recorded [t[35] = -2.24, p < 0.05). Additional motivational elements did not influence the usage behavior by older adults. CONCLUSION Until now only a small proportion of older adults used smartphone health apps, despite the ubiquitous availability. These apps have to be tailored to the requirements of older adults so that the market will be opened up to them. Using self-monitoring apps can help older adults to structure their daily routine despite their disease.
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Affiliation(s)
- A Steinert
- Forschungsgruppe Geriatrie, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Deutschland.
| | - M Haesner
- Forschungsgruppe Geriatrie, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Deutschland
| | - E Steinhagen-Thiessen
- Forschungsgruppe Geriatrie, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Deutschland
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Lingner H, Großhennig A, Flunkert K, Buhr-Schinner H, Heitmann R, Tönnesmann U, van der Meyden J, Schultz K. ProKaSaRe Study Protocol: A Prospective Multicenter Study of Pulmonary Rehabilitation of Patients With Sarcoidosis. JMIR Res Protoc 2015; 4:e134. [PMID: 26679102 PMCID: PMC4704944 DOI: 10.2196/resprot.4948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/19/2015] [Accepted: 09/20/2015] [Indexed: 01/16/2023] Open
Abstract
Background Available data assessing the efficacy of pulmonary rehabilitation for patients with chronic sarcoidosis are scant; for Germany, there are none at all. Objective To gain information about the benefit of in-house pulmonary rehabilitation for patients with chronic sarcoidosis and for the health care system, we intend to collect data in a prospective multicenter “real-life” cohort trial. Methods ProKaSaRe (Prospektive Katamnesestudie Sarkoidose in der pneumologischen Rehabilitation) [Prospective Catamnesis Study of Sarcoidosis in Pulmonary Rehabilitation] will assess a multimodal 3-week inpatient pulmonary rehabilitation program for adult patients with chronic sarcoidosis over a 1-year follow-up time. Defined specific clinical measurements and tests will be performed at the beginning and the end of the rehabilitation. In addition, questionnaires concerning health-related quality of life and the patients’ symptoms will be provided to all patients. Inclusion criteria will be referral to one of the 6 participating pulmonary rehabilitation clinics in Germany for sarcoidosis and age between 18 and 80 years. Patients will only be excluded for a lack of German language skills or the inability to understand and complete the study questionnaires. To rule out seasonal influences, the recruitment will take place over a period of 1 year. In total, at least 121 patients are planned to be included. A descriptive statistical analysis of the data will be performed, including multivariate analyses. The primary outcomes are specific health-related quality of life (St George’s Respiratory Questionnaire) and exercise capacity (6-minute walk test). The secondary outcomes are several routine lung function and laboratory parameters, dyspnea scores and blood gas analysis at rest and during exercise, changes in fatigue, psychological burden, and generic health-related quality of life (36-item Short Form Health Survey). Results Funding was obtained on October 12, 2010; enrollment began on January 15, 2011 and was completed by January 14, 2012. Results are anticipated late summer 2015. Conclusions Due to the large number of participants, we expect to obtain representative findings concerning the effectiveness of pulmonary rehabilitation for patients with sarcoidosis and to provide a dataset of assessed objective and subjective short- and long-term changes due to pulmonary rehabilitation. The results should form the basis for the planning of a randomized controlled trial. Trial Registration German Clinical Trials Register: DRKS00000560; https://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00000560 (Archived by WebCite® at http://www.webcitation.org/6dKb5X87R)
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Affiliation(s)
- Heidrun Lingner
- Centre for Public Health and Healthcare, Hannover Medical School, Hannover, Germany
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Wang P, Chen C, Yang R, Wu Y. Psychometric evaluation of health related quality of life among rural-to-urban migrants in China. Health Qual Life Outcomes 2015; 13:155. [PMID: 26399311 PMCID: PMC4581414 DOI: 10.1186/s12955-015-0350-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/14/2015] [Indexed: 11/15/2022] Open
Abstract
Objectives Our study discusses health related quality of life (HRQOL) as measured by 36-item Short Form (SF-36) for rural-to-urban migrants in China, and assesses the validity and reliability of the SF-36 for this group. Methods In 2012,765 rural-to-urban migrant respondents chosen by probability and the non-probability sampling methods have completed the survey in Wuhan, Mid-China. The reliability of SF-36 is analyzed by Cronbach's alpha (α) coefficient, split-half coefficient, theta (θ) and omega (Ω) coefficient, the validity is calculated by confirmatory factor analysis (CFA) and known-group methods. Result Split-half reliability coefficient is 0.717. Cronbach's alpha coefficient is 0.776. Theta and omega coefficient are 0.862 and 0.903 respectively. CFA statistical analysis results are shown as follows: GFI = 0.926, Chi-Square/Df = 2.059, RMSEA = 0.037, CFI = 0.939. Physical and mental component summary (PCS/MCS) scores are tabulated by known-group variables and show a statistical significance. Conclusion In general, SF-36 is a reliable and valid instrument for measuring HRQOL of rural-to-urban migrants in China. Furthermore, Chinese migrants have lived and worked in a hard environment, their salaries are much lower than that of the counterparts, HRQOL of this group is also a little lower and deserves much attention from society.
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Affiliation(s)
- Peigang Wang
- Wuhan University, School of Public Health, Global Health Institute, Wuhan, China
| | - Cen Chen
- Renmin University of China, School of Statistics, Beijing, China
| | - Ronghua Yang
- Hohai University, School of International Languages and Cultures, Nanjing, China
| | - Yan Wu
- Wuhan University, School of Information Management, Wuhan, China.
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Niemier K, Schindler M, Volk T, Baum K, Wolf B, Eberitsch J, Seidel W. [Efficacy of epidural steroid injections for chronic lumbar pain syndromes without neurological deficits. A randomized, double blind study as part of a multimodal treatment concept]. Schmerz 2015; 29:300-7. [PMID: 26099752 DOI: 10.1007/s00482-015-0020-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic lumbar pain syndromes without neurological deficits are generated by a multitude of causes. Functional, morphological and psychosocial factors are discussed. In many cases a diseased intervertebral disc is found on radiological examination but the clinical relevance of these findings is not clear. For this study it was postulated that a diseased disc results in a local inflammatory reaction therefore causing pain and impairing treatability of patients. An epidural injection of steroids can reduce inflammation and therefore improve treatability and ultimately treatment outcome. METHODS A double blind randomized prospective trial was carried out. Patients treated in hospital for a chronic lumbar pain syndrome without neurological deficits within a multimodal treatment program were screened for indications for an epidural steroid injection (e.g. diseased lumbar disc and intention to treat). Patients eligible for the study were randomized into two groups. The treatment group received an epidural injection of 80 mg triamcinolone and 8 ml bupivacaine 0.25 %. The control group received only an epidural injection of 8 ml bupivacaine 0.25 %. RESULTS In both groups pain intensity and treatability showed a statistically significant improvement after the epidural injection. The differences between the control and treatment groups were small and not clinically relevant. A small subgroup might profit from the steroid injection. In addition the treatability was dependent on psychometric values and the long-term outcome from a reduction of muscular skeletal dysfunctions. DISCUSSION After the epidural injection the decrease in pain and increase in treatability was statistically significant. The mechanism of the improvement is not clear and should be examined further. The epidural injection of a steroid in this subgroup of patients did not lead to a clinical improvement in the outcome.
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Affiliation(s)
- K Niemier
- Klinik für Manuelle Therapie Hamm, Ostenallee 83, 59071, Hamm, Deutschland,
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[Quality of life in dermatology. From measurement to practical implementation]. Hautarzt 2015; 66:287-96; quiz 297-8. [PMID: 25822586 DOI: 10.1007/s00105-015-3599-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Health-related quality of life has not only been established as an important patient-reported outcome measure in patient care but has been defined as an evaluation criterion for therapies in the German Code of Social Law as well as in the guidelines of the American Food and Drug Administration and of the European Medicines Agency (EMA). Quality of life can be measured in a standardised manner. Validated questionnaires are available for recording specific problems of patients with, for example, skin diseases. Measuring quality of life has not yet been implemented into daily dermatological routine, although (1) studies have confirmed that the measurement of quality of life offers major benefits for the treatment of skin diseases, and (2) first experiences in implementing quality of life measurement into practice have been positive. The further implementation of systemically measuring quality of life requires advancements in automated measurement and the assumption of cost by social health insurances.
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131
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Schaller A, Dejonghe L, Haastert B, Froboese I. Physical activity and health-related quality of life in chronic low back pain patients: a cross-sectional study. BMC Musculoskelet Disord 2015; 16:62. [PMID: 25887138 PMCID: PMC4373082 DOI: 10.1186/s12891-015-0527-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 03/11/2015] [Indexed: 11/17/2022] Open
Abstract
Background The aim of the present study was to identify the relationship of physical activity (PA) and Health-Related Quality of Life (HRQoL) in patients suffering from low back pain (LBP). Methods The present evaluation was conducted as a cross-sectional study based on baseline data of an randomized controlled trial on the effectiveness of an intervention promoting PA. Patients answered a questionnaire on domain specific PA (GPAQ) and HRQoL (EQ-5D-5 L). Furthermore, sociodemographic and indication-specific variables as well as work-related aspects were assessed. Associations of PA and HRQoL were estimated by means of regression analysis: one regression model only included domain specific PA (model 1) and a second regression model additionally included further variables (model 2). Results 412 patients completed the questionnaire. Model 1 showed opposed effects of workplace and leisure time PA: while workplace PA showed a negative association (β = −0.064; p = 0.04), a positive association of leisure time PA could be proved (β = 0.068; p = 0.01). Model 2 showed that only the variables “current work ability” (β = −0.030; p < 0.01) and “intensity of pain” (β = 0.104; p < 0.01) significantly contributed to explain the variance in HRQoL (model 2). Conclusions The present results indicate the necessity of a differentiation of workplace and leisure time PA in the context of assessing health-enhancing effects of PA in LBP patients. In the context of HRQoL it must be assumed that the relevance of PA might be overestimated. Further research should be performed on predictors of HRQoL and thereby particular attention should be paid on the patients’ work-related and indication-specific aspects.
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Affiliation(s)
- Andrea Schaller
- Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
| | - Lea Dejonghe
- Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
| | | | - Ingo Froboese
- Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
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Khil L, Wellmann J, Berger K. Impact of combined sensory impairments on health-related quality of life. Qual Life Res 2015; 24:2099-103. [PMID: 25669155 DOI: 10.1007/s11136-015-0941-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE To analyse the impact of single/combined sensory impairment on health-related quality of life (HRQOL). METHODS Data from 1102 participants (mean age = 51.4 years) of the Dortmund Health Study were analysed. HRQOL was assessed by the Short Form 36 Health Survey (SF-36). Sensory impairment was measured with validated tests. Each impairment variable was coded into four categories (no impairment, mild, moderate, and severe impairment). Data were analysed with general linear models adjusted for possible confounders. The reference category was the group of no sensory impairment. RESULTS Sensory impairments did not influence the mental component score (MCS). Severe auditory impairment (-3.7, 95 % CI -6.3, -1.2) and olfactory impairment (-3.3, 95 % CI -5.6, -1.1) were related to a reduction in the physical component score (PCS). Auditory plus visual and gustatory plus visual impairments had a stronger effect on PCS than the respective impairments alone. For most of the other impairment combinations, additive effects were observed. CONCLUSIONS Sensory impairments reduced self-reported physical but not mental health scores. Combined sensory impairment worsened the impact of single sensory impairment on health.
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Affiliation(s)
- Laura Khil
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany,
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Krawiec M, Kuczkowski M, Kruszewicz AG, Wieliczko A. Prevalence and genetic characteristics of Salmonella in free-living birds in Poland. BMC Vet Res 2015; 11:15. [PMID: 25636375 PMCID: PMC4316766 DOI: 10.1186/s12917-015-0332-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 01/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Salmonella species are widespread in the environment, and occur in cattle, pigs, and birds, including poultry and free-living birds. In this study, we determined the occurrence of Salmonella in different wild bird species in Poland, focusing on five Salmonella serovars monitored in poultry by the European Union: Salmonella serovars Enteritidis, Typhimurium, Infantis, Virchow, and Hadar. We characterized their phenotypic and genetic variations. Isolates were classified into species and subspecies of the genus Salmonella with a polymerase chain reaction (PCR) assay. The prevalence of selected virulence genes (spvB, spiA, pagC, cdtB, msgA, invA, sipB, prgA, spaN, orgA, tolC, ironN, sitC, ipfC, sifA, sopB, and pefA) among the isolated strains was determined. We categorized all the Salmonella ser. Typhimurium strains with enterobacterial repetitive intergenic consensus (ERIC)-PCR. Results Sixty-four Salmonella isolates were collected from 235 cloacal swabs, 699 fecal samples, and 66 tissue samples (6.4% of 1000 samples) taken from 40 different species of wild birds in Poland between September 2011 and August 2013. The largest numbers of isolates were collected from Eurasian siskin and greenfinch: 33.3% positive samples for both. The collected strains belonged to one of three Salmonella subspecies: enterica (81.25%), salamae (17.19%), or houtenae (1.56%). Eighteen strains belonged to Salmonella ser. Typhimurium (28.13%), one to ser. Infantis (1.56%), one to ser. Virchow (1.56%), and one to ser. Hadar (1.56%). All isolates contained spiA, msgA, invA, lpfC, and sifA genes; 94.45% of isolates also contained sitC and sopB genes. None of the Salmonella ser. Typhimurium strains contained the cdtB gene. The one Salmonella ser. Hadar strain contained all the tested genes, except spvB and pefA; the one Salmonella ser. Infantis strain contained all the tested genes, except tspvB, pefA, and cdtB; and the one Salmonella ser. Virchow strain contained all the tested genes, except spvB, pefA, cdtB, and tolC. The Salmonella ser. Typhimurium strains varied across the same host species, but similarity was observed among strains isolated from the same environment (e.g., the same bird feeder or the same lake). Conclusions Our results confirm that some wild avian species are reservoirs for Salmonella serotypes, especially Salmonella ser. Typhimurium.
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Affiliation(s)
- Marta Krawiec
- Department of Epizootiology and Clinic of Bird and Exotic Animals, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Pl. Grunwaldzki 45, 50-366, Wrocław, Poland.
| | - Maciej Kuczkowski
- Department of Epizootiology and Clinic of Bird and Exotic Animals, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Pl. Grunwaldzki 45, 50-366, Wrocław, Poland.
| | | | - Alina Wieliczko
- Department of Epizootiology and Clinic of Bird and Exotic Animals, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Pl. Grunwaldzki 45, 50-366, Wrocław, Poland.
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Tietze AL, Zernikow B, Michel E, Blankenburg M. Sleep disturbances in children, adolescents, and young adults with severe psychomotor impairment: impact on parental quality of life and sleep. Dev Med Child Neurol 2014; 56:1187-1193. [PMID: 24962083 DOI: 10.1111/dmcn.12530] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2014] [Indexed: 11/26/2022]
Abstract
AIM In childhood, severe psychomotor impairment (SPMI) is associated with profound sleep disturbances. With the help of newly developed and validated measures, we systematically assessed how much a child's sleep disturbance affects parental sleep and quality of life (QoL) in this specific patient group. METHOD Parents and their children with SPMI were enrolled from three outpatient centers and one in-patient center in Germany. We administered a set of questionnaires to the parents that addressed their child's sleep quality, the sleep disturbance-related parental burden, and the impact on both parental sleep and QoL. Additional questionnaires were used to gather data describing our sample group to allow for comparison with published norms. RESULTS Parents of 214 children, adolescents, and young adults with SPMI (114 males, 100 females; mean age 10y 5mo, SD 5y 6mo, range 0.1-25y) responded to the questionnaire set (response rate of 66%). We found severe impairment of parental health status and QoL. More than 50% of the parents suffered from a sleep disorder (e.g. prolonged sleep latency, shortened sleep duration). Sleep disturbances in children, adolescents, and young adults correlated strongly with parental sleep disturbances, parental impairment of physical and mental functioning, parental social functioning, and parental working ability. INTERPRETATION Sleep-related difficulties have a significant sociomedical impact on the parents of children, adolescents, and young adults with complex neurological diseases. Typically, parents are severely affected in various aspects of daily living. There is a need for novel diagnostic and therapeutic approaches that match the complex sociomedical needs of these patients and their families.
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Affiliation(s)
- Anna L Tietze
- Children's Pain Therapy and Pediatric Palliative Care, Witten/Herdecke University, Witten, Germany
| | - Boris Zernikow
- Children's Pain Therapy and Pediatric Palliative Care, Witten/Herdecke University, Witten, Germany
| | - Erik Michel
- Children's Hospital Klinikum Friedrichshafen, Friedrichshafen, Germany
| | - Markus Blankenburg
- Paediatrics 1 - Paediatric Neurology and Social Paediatrics, Klinikum Stuttgart Olgahospital / Frauenklinik Kriegsbergstrasse, Stuttgart, Germany
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Schmitt A, Reimer A, Kulzer B, Haak T, Gahr A, Hermanns N. Assessment of diabetes acceptance can help identify patients with ineffective diabetes self-care and poor diabetes control. Diabet Med 2014; 31:1446-51. [PMID: 25047992 DOI: 10.1111/dme.12553] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 04/16/2014] [Accepted: 07/17/2014] [Indexed: 11/28/2022]
Abstract
AIMS To estimate the associations between insufficient diabetes acceptance and relevant diabetes outcomes. METHODS A total of 320 patients completed questionnaires on diabetes non-acceptance (the Acceptance and Action Diabetes Questionnaire), diabetes distress (the Problem Areas in Diabetes Scale), depressive mood (the Center for Epidemiologic Studies Depression Scale), coping with illness (the Freiburg Questionnaire of Coping with Illness), self-care activities (the Summary of Diabetes Self-Care Activities Measure) and quality of life (the Short Form-36 Health Questionnaire). A six-item version of the Acceptance and Action Diabetes Questionnaire showing good reliability and validity was established, and the associations between insufficient acceptance and clinical outcomes were estimated. RESULTS Higher diabetes non-acceptance correlated significantly with less active coping (-0.37), reduced self-care (-0.43) and higher HbA1c levels (0.31), higher diabetes distress (0.53) and more depressive symptoms (0.36). Correlations of diabetes non-acceptance with diabetes self-care/glycaemic control were significantly higher than were those of depressive mood or diabetes distress with these criteria. CONCLUSIONS Low diabetes acceptance is associated with impaired self-care and glycaemic control. Assessment of diabetes acceptance may facilitate the detection of patients at high risk and may present an essential target for treatments to improve diabetes control that is more relevant than elevated depressive mood or diabetes distress.
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MESH Headings
- Adaptation, Psychological
- Adult
- Attitude to Health
- Combined Modality Therapy/psychology
- Depression/epidemiology
- Depression/prevention & control
- Diabetes Complications/epidemiology
- Diabetes Complications/prevention & control
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/psychology
- Diabetes Mellitus, Type 2/therapy
- Female
- Germany/epidemiology
- Humans
- Hyperglycemia/prevention & control
- Hypoglycemia/prevention & control
- Male
- Middle Aged
- Patient Compliance
- Prevalence
- Psychiatric Status Rating Scales
- Quality of Life
- Self Care/psychology
- Stress, Psychological/epidemiology
- Stress, Psychological/prevention & control
- Surveys and Questionnaires
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Affiliation(s)
- A Schmitt
- Research Institute of the Diabetes Academy Mergentheim, Bad Mergentheim, Germany; German Diabetes Centre Mergentheim, Bad Mergentheim, Germany
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Robinski M, Mau W, Lamprecht J, Krauth C, Girndt M. The Choice of Renal Replacement Therapy (CORETH) project: study design and methods. Clin Kidney J 2014; 7:575-81. [PMID: 25859375 PMCID: PMC4389146 DOI: 10.1093/ckj/sfu111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/03/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To date, research has neglected the patient's psychosocial and cognitive conditions as contributing factors to dialysis modality decision-making. Hence, the Choice of Renal Replacement Therapy (CORETH) study aims to examine these conditions with regard to their impact on the choice. Here we describe the design of the multicentre study, which is supported by a grant from the German Ministry for Education and Research. METHODS Two groups of patients will be compared after having chosen peritoneal or haemodialysis as permanent treatment. About 1200 participants from 50 dialysis centres all over Germany will be questioned. The questionnaire addresses social, psychological and shared decision-making aspects. Furthermore, cognitive functioning will be tested. For an economic evaluation direct and indirect costs of treatment will be calculated. Changes will be examined through a one-year follow-up. CONCLUSIONS The results will enlighten the treatment choice under the German healthcare system. They will provide further insight regarding the discussion on patient autonomy. From the patients' perspective, the results will help to strengthen their participation in the individual process of health-related decision-making.
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Affiliation(s)
- Maxi Robinski
- Institute for Rehabilitation Medicine , Medical Faculty of the Martin-Luther-University Halle-Wittenberg , Halle (Saale) , Germany
| | - Wilfried Mau
- Institute for Rehabilitation Medicine , Medical Faculty of the Martin-Luther-University Halle-Wittenberg , Halle (Saale) , Germany
| | - Juliane Lamprecht
- Institute for Rehabilitation Medicine , Medical Faculty of the Martin-Luther-University Halle-Wittenberg , Halle (Saale) , Germany
| | - Christian Krauth
- Institute of Epidemiology, Social Medicine and Health Care System Research , Hannover Medical School , Hannover , Germany
| | - Matthias Girndt
- Department of Internal Medicine II , Medical Faculty of the Martin-Luther-University Halle-Wittenberg , Halle (Saale) , Germany
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Abstract
Patient-reported outcomes are major components of decision making in clinical research, reimbursement, health policy and health care for psoriasis. The most important construct in patient-reported outcomes is health-related quality of life (HRQoL) which encompasses the individual's well-being with respect to health. HRQoL cannot directly be measured but is assessed in single dimensions, especially physical, emotional, social and functional aspects. For this, disease- and condition-specific instruments are used. Psoriasis is a chronic inflammatory disease affecting the skin as well as other tissues and organ systems. Patients suffer from a large scale of impairments, for example, physical symptoms, stigmatization and embarrassment, psychological strain and disabilities in profession. Improvement of HRQoL is a major objective of disease management. Current knowledge on determinants of HRQoL and the treatments available increase QoL in clinical care.
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Affiliation(s)
- Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing - IVDP, University Medical Center Hamburg-Eppendorf, Hamburg, Martinistrasse 52, D - 20246 Hamburg, Germany
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138
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Sasse N, Gibbons H, Wilson L, Martinez R, Sehmisch S, von Wild K, von Steinbüchel N. Coping strategies in individuals after traumatic brain injury: associations with health-related quality of life. Disabil Rehabil 2014; 36:2152-60. [DOI: 10.3109/09638288.2014.893029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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139
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Ahrberg AB, Leimcke B, Tiemann AH, Josten C, Fakler JK. Missed foot fractures in polytrauma patients: a retrospective cohort study. Patient Saf Surg 2014; 8:10. [PMID: 24568599 PMCID: PMC3944986 DOI: 10.1186/1754-9493-8-10] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 02/17/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient's life. The aim of this study is to find out how many of these fractures are overlooked in a Level I trauma center and what the consequences for the patients are hypothesing that patients with a delayed diagnosis will have worse clinical results. METHODS Forty-seven patients (7.3%) with foot fractures could be identified in 642 polytrauma patients, retrospectively. All patients were divided into two groups: early diagnosed fractures and delayed diagnosed fractures, the latter defined as diagnosed after Secondary Survey. Patients were evaluated according to the Hannover Outcome Score, the Short Form-36 Health Survey, the AOFAS Score and the Hannover Scoring System. The average follow-up was 5 years and 8 months. Reasons for overlooking a foot fracture were analyzed. RESULTS The foot fracture was early diagnosed in 26 (55.3%) patients, but delayed in 21 (44.7%). There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results. CONCLUSIONS In summary, the results of this study show that foot injuries can be a safety problem for the patient and the examination of the feet in the trauma room has to be a compulsory part of the algorithm. Although the majority of delayed diagnosed foot fractures demonstrated comparable results to the immediately diagnosed fractures, approximately 10% might have benefited from an earlier diagnosis. Even if there were no significant differences in the clinical results, we have to be aware that missing a fracture in the foot can lead to worse results in the complete polytrauma care.
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Affiliation(s)
- Annette B Ahrberg
- Department of Orthopedics, Traumatology and Plastic Surgery, University of Leipzig, Leipzig, Germany.
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140
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Long-term efficacy of an attachment-based parental training program for single mothers and their children: a randomized controlled trial. J Public Health (Oxf) 2014. [DOI: 10.1007/s10389-013-0605-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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141
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Kempf K, Martin S. Autonomous exercise game use improves metabolic control and quality of life in type 2 diabetes patients - a randomized controlled trial. BMC Endocr Disord 2013; 13:57. [PMID: 24321337 PMCID: PMC3880220 DOI: 10.1186/1472-6823-13-57] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 10/15/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Lifestyle intervention in type 2 diabetes mellitus (T2DM) is effective but needs a special local setting and is costly. Therefore, in a randomized-controlled trial we tested the hypothesis that the autonomous use of the interactive exercise game Wii Fit Plus over a period of 12 weeks improves metabolic control, with HbA1c reduction as the primary outcome, and weight loss, reduction of cardiometabolic risk factors, physical activity and quality of life (secondary outcomes) in T2DM patients. METHODS Participants (n = 220) were randomized into an intervention and a control group. The intervention group was provided with a Wii console, a balance board and the exercise game Wii Fit Plus for 12 weeks. The control group remained under routine care and received the items 12 weeks later. At baseline and after 12 weeks (and for the control group additionally after 12 weeks of intervention) the participants' health parameters, medication, physical activity and validated questionnaires for quality of life (PAID, SF12, WHO-5, CES-D) were requested and compared in a complete case analysis using the Mann-Whitney test and the Wilcoxon signed rank test. RESULTS 80% of participants completed the 12-week study. Patients in the intervention group significantly improved HbA1c (from 7.1 ± 1.3% to 6.8 ± 0.9%; -0.3 ± 1.1%; p = 0.0002) in comparison to the control group (from 6.8 ± 0.9% to 6.7 ± 0.7%; -0.1 ± 0.5%) and also significantly reduced fasting blood glucose (from 135.8 ± 38.9 mg/dl to 126.6 ± 36.6 mg/dl; p = 0.04), weight (from 97.6 ± 19.2 kg to 96.3 ± 18.7 kg; p < 0.001) and body mass index (from 34.1 ± 6.5 kg/m2 to 33.5 ± 6.5 kg/m2; p < 0.001). Daily physical activity increased significantly (p < 0.001). Diabetes-dependent impairment, mental health, subjective wellbeing and quality of life also improved significantly, and the number of patients with depression decreased. Similar improvements were seen in the control group after exercise game intervention. CONCLUSIONS In this trial a low-threshold intervention with the interactive exercise game Wii Fit Plus was able to motivate T2DM patients to improve physical activity, glucometabolic control and quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT01735643.
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Affiliation(s)
- Kerstin Kempf
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany
| | - Stephan Martin
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany
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142
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Self-Awareness and Health-Related Quality of Life After Traumatic Brain Injury. J Head Trauma Rehabil 2013; 28:464-72. [DOI: 10.1097/htr.0b013e318263977d] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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143
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Nagl M, Gramm L, Heyduck K, Glattacker M, Farin E. Development and Psychometric Evaluation of a German Version of the PROMIS® Item Banks for Satisfaction With Participation. Eval Health Prof 2013; 38:160-80. [PMID: 24072786 DOI: 10.1177/0163278713503468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Patient Reported Outcomes Measurement Information System (PROMIS) initiative aims to provide reliable and precise item banks measuring patient-reported outcomes in different health domains. The aim of the present work was to provide a German translation of the PROMIS item banks for satisfaction with participation and to psychometrically test these German versions. Cognitive interviews followed a forward-backward translation. Distribution characteristics, unidimensionality, Rasch model fit, reliability, construct validity, and internal responsiveness were tested in 262 patients with chronic low back pain undergoing rehabilitation. Results for the final 13- and 10-item German static scales (Satisfaction with Participation in Social Roles-German version [PSR-G] and Satisfaction for Participation in Discretionary Social Activities-German version [PSA-G]) regarding unidimensionality were satisfactory. The scales are reliable and show good Rasch model fit and distribution characteristics. Both scales are sensitive to small to moderate clinical changes, and we observed initial proof of construct validity. These German versions of the Satisfaction with Participation scales can be recommended to assess participation in a clinical context. The scales' applicability in other contexts should be examined.
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Affiliation(s)
- Michaela Nagl
- Institute of Quality Management and Social Medicine, University Freiburg-Medical Center, Freiburg, Germany
| | - Lukas Gramm
- Institute of Quality Management and Social Medicine, University Freiburg-Medical Center, Freiburg, Germany
| | - Katja Heyduck
- Institute of Quality Management and Social Medicine, University Freiburg-Medical Center, Freiburg, Germany
| | - Manuela Glattacker
- Institute of Quality Management and Social Medicine, University Freiburg-Medical Center, Freiburg, Germany
| | - Erik Farin
- Institute of Quality Management and Social Medicine, University Freiburg-Medical Center, Freiburg, Germany
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144
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Hensel M, Frenzel J, Späker M, Keil E, Reinhold N. [Postoperative pain management after minimally invasive hysterectomy: thoracic epidural analgesia versus intravenous patient-controlled analgesia]. Anaesthesist 2013; 62:797-807. [PMID: 24057760 DOI: 10.1007/s00101-013-2234-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/25/2013] [Accepted: 08/01/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND In view of the development of innovative and non-traumatic surgical techniques, postoperative pain management should be carried out depending on the invasiveness of the intervention. In the present study two analgesic strategies were compared in patients undergoing minimally invasive hysterectomy: epidural analgesia (EDA) and intravenous patient-controlled analgesia (iv-PCA). MATERIAL AND METHODS For this prospective case controlled study 60 women with benign uterine diseases undergoing vaginal hysterectomy (VH) or laparoscopically assisted vaginal hysterectomy (LAVH) were enrolled. Patients were divided for analysis into two groups (n=30 each) according to the postoperative analgesic strategy (EDA group versus iv-PCA group). A matched-pair analysis was applied (matching criteria: risk assessment, surgeon and age of patient) to minimize the differences between both groups. Patients were evaluated with respect to the extent of pain determined by a numeric rating scale (NRS 0-10 scale), analgesic consumption, rate of postoperative nausea and vomiting (PONV), mobilization from bed, oral intake of nutrition, complications, duration of stay in the recovery room as well as hospital stay and health-related quality of life (SF-36 Health Survey; collected before and 6 weeks after surgery). RESULTS Laparoscopically assisted removal of the uterus was carried out in 22 women and by vaginal hysterectomy in 38 women. No significant differences between the study groups were seen in the duration of surgery (iv-PCA 58 ± 25 min versus EDA 60 ± 26 min). Demographic data of both groups as well as intraoperative hemodynamic and respiratory parameters were comparable to a great extent. Compared to the iv-PCA group, women in the EDA group showed lower NRS values (p<0.01): recovery room admission 4.7 ± 2.5 iv-PCA vs. 0.9 ± 1.3 EDA, recovery room discharge 3.8 ± 1.8 iv-PCA vs. 1.0 ± 1.2 EDA, day of surgery at 8 p.m. 5.0 ± 2.1 iv-PCA vs. 1.8 ± 2.3 EDA and first postoperative day at 8 a.m. 3.5 ± 1.7 iv-PCA vs. 1.9 ± 2.2 EDA. In addition, less PONV (iv-PCA 9/30 vs. EDA 1/30, p<0.01), less shivering (iv-PCA 8/30 vs. EDA 2/30, p<0.05), reduced fatigue (iv-PCA 26/30 vs. EDA 9/30, p<0.05) and a lower consumption of analgesics were found. Average postoperative requirement for piritramide in the iv-PCA group was 7 mg (range 0-24 mg) on the day of surgery and 5 mg (0-39 mg) on the first postoperative day. In the EDA group no opiate medication was given postoperatively (p<0.01). Duration of stay in the recovery room was shorter in the EDA group (71 ± 32 min vs. 50 ± 13 min, p<0.05). Hospital stay was 5 days on average in both groups. There were no surgical complications or epidural catheter-related complications. Because of urinary retention catheterization of the bladder had to be made in 3 patients of the iv-PCA group and 13 patients of the EDA group (p<0.05). Furthermore, the possibility to take a shower postoperatively was restricted in the EDA group because the epidural catheter was in place and thereby hygiene concerns. Regarding the early oral nutritional intake as well as postoperative mobilization, no significant differences between groups were found. In comparison with the preoperative status, the results regarding health-related quality of life were significantly better for both groups after a follow-up of 6 weeks (p<0.01); however, this effect was especially pronounced in the EDA group (p<0.05). CONCLUSIONS To reduce the number of patients suffering from postoperative pain a procedure-specific pain management should be developed. The results of this study have shown that even in minimally invasive surgery, such as vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy there are some advantages for epidural analgesia compared to intravenous patient-controlled analgesia. In particular reduced pain intensity, lower need for analgesics and reduced occurrence of PONV can lead to excellent patient comfort, fast recovery as well as positive effects on health-related quality of life. However, there are also some disadvantages such as an increased rate of urinary retention and restriction of mobility.
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Affiliation(s)
- M Hensel
- Abteilung Anästhesiologie und Intensivmedizin, Park-Klinik-Weissensee, Schönstr. 80, 13086, Berlin, Deutschland,
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Elsner F, Sonntag B, Radbruch L, Sabatowski R. Improvement of health care for headache patients with a regional pain management network. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/1568569042664558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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146
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Lauche R, Langhorst J, Dobos GJ, Cramer H. Clinically meaningful differences in pain, disability and quality of life for chronic nonspecific neck pain – A reanalysis of 4 randomized controlled trials of cupping therapy. Complement Ther Med 2013; 21:342-7. [DOI: 10.1016/j.ctim.2013.04.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/17/2013] [Accepted: 04/29/2013] [Indexed: 10/26/2022] Open
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Moser MT, Künzler A, Nussbeck F, Bargetzi M, Znoj HJ. Higher emotional distress in female partners of cancer patients: prevalence and patient-partner interdependencies in a 3-year cohort. Psychooncology 2013; 22:2693-701. [DOI: 10.1002/pon.3331] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 05/13/2013] [Accepted: 05/13/2013] [Indexed: 01/06/2023]
Affiliation(s)
| | - Alfred Künzler
- Clinical Psychology; University of Bern; Bern Switzerland
- Division of Hematology/Oncology; Cantonal Hospital Aarau; Aarau Switzerland
- Onco-Psychology; Psychiatric Services Aargau; Switzerland
| | - Fridtjof Nussbeck
- Department of Psychology; University of Zurich; Zurich Switzerland
- Department of Psychology; University of Bielefeld; Bielefeld Germany
| | - Mario Bargetzi
- Division of Hematology/Oncology; Cantonal Hospital Aarau; Aarau Switzerland
| | - Hans J. Znoj
- Clinical Psychology; University of Bern; Bern Switzerland
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148
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Weiss J, Quante S, Xue F, Muche R, Reuss-Borst M. Effectiveness and acceptance of acupuncture in patients with chronic low back pain: results of a prospective, randomized, controlled trial. J Altern Complement Med 2013; 19:935-41. [PMID: 23738680 DOI: 10.1089/acm.2012.0338] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To investigate the effectiveness of additional acupuncture in patients with chronic low back pain participating in an inpatient rehabilitation program. DESIGN Patients were randomly assigned to one of two groups (A and B), both receiving a standard rehabilitation program according to German guidelines. Patients in group A additionally underwent acupuncture twice weekly, conducted by two Chinese physicians with education in Traditional Chinese Medicine (TCM). At the beginning and end of the program, as well as at 3 months after, patients completed questionnaires about health-related quality of life (Short-Form 36 Health Survey [SF-36]), sociodemographic and clinical data, attitude towards TCM, pain, and adverse events. SETTING Inpatient rehabilitation clinic in Germany. PATIENTS Patients with chronic low back pain participating in an inpatient rehabilitation program. OUTCOME MEASURES Acceptance of acupuncture, health-related quality of life, and pain/symptoms. RESULTS One hundred and forty-three patients were analyzed: 74 in group A (intervention) and 69 in group B (controls); 67% were men and 33% were women, with a mean age of 50.7 years. Acceptance of TCM was excellent: 89% of the patients would want TCM to be integrated into standard inpatient rehabilitation, and 83% would even have paid for TCM if necessary. Responses to SF-36 questionnaires showed that group A reported significantly better physical functioning, general health, vitality, and emotional role than group B. Pain outcomes in group A were superior to those in group B. Specifically, pain with sitting/standing, pain upon carrying loads of 10 kg or more, and prickling in hands and feet were significantly diminished. CONCLUSION Acupuncture was highly accepted and had positive effects in patients with chronic low back pain. These results show that acupuncture can be an effective, well-tolerated therapy with no major adverse events.
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Miche M, Huxhold O, Stevens NL. A latent class analysis of friendship network types and their predictors in the second half of life. J Gerontol B Psychol Sci Soc Sci 2013; 68:644-52. [PMID: 23696031 DOI: 10.1093/geronb/gbt041] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Friendships contribute uniquely to well-being in (late) adulthood. However, studies on friendship often ignore interindividual differences in friendship patterns. The aim of this study was to investigate such differences including their predictors. METHOD The study builds on Matthews's qualitative model of friendship styles. Matthews distinguished 3 approaches to friendship differing by number of friends, duration of friendships, and emotional closeness. We used latent class analysis to identify friendship network types in a sample of middle-aged and older adults aged 40-85 years (N = 1,876). Data came from the German Aging Survey (DEAS). RESULTS Our analysis revealed 4 distinct friendship network types that were in high congruence with Matthews's typology. We identified these as a discerning style, which focuses on few close relationships, an independent style, which refrains from close engagements, and 2 acquisitive styles that both acquire new friends across their whole life course but differ regarding the emotional closeness of their friendships. Socioeconomic status, gender, health, and network-disturbing and network-sustaining variables predicted affiliations with network types. DISCUSSION We argue that future studies should consider a holistic view of friendships in order to better understand the association between friendships and well-being in the second half of life.
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Affiliation(s)
- Martina Miche
- Department of Psychological Aging Research, Heidelberg University, Heidelberg, Germany.
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Is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial. Gen Hosp Psychiatry 2013; 35:160-7. [PMID: 23218844 DOI: 10.1016/j.genhosppsych.2012.10.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 10/23/2012] [Accepted: 10/23/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE There are no studies investigating the efficacy of short-term psychodynamic psychotherapy in primary fibromyalgia syndrome (FMS). We conducted a randomized controlled trial evaluating an adapted form of individual short-term psychodynamic psychotherapy (ASTPP) versus primary care management (TAU). The study focused on FMS patients with psychiatric comorbidity. METHODS Forty-six female patients with FMS and an International Classification of Diseases, 10th Revision diagnosis of a comorbid depression or anxiety disorder were recruited in a hospital setting. Participants were randomized to receive either ASTPP (25 sessions, 1 session/week) or TAU (4 consultations/6 months). Outcome measures included the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Pain Disability Index, the Symptom Checklist 27 and the health-related quality of life. Primary endpoints of the outcome assessment were the FIQ total score and the HADS depression scale at 12-month follow-up. RESULTS Both treatments were effective in reducing the FIQ total score (ES=0.56 and ES=0.75, respectively). Intent-to-treat analyses failed to provide evidence suggesting a marked superiority of individual psychodynamic psychotherapy as compared to TAU. CONCLUSIONS A high-standard routine treatment focusing on the improvement of health behavior and including antidepressant and analgesic medication is equally effective as a short-term individual psychodynamic psychotherapy in improving fibromyalgia-related symptoms.
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