610 Medizin, Gesundheit
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A report from the World Economic Forum (2019) stated loneliness as the third societal stressor in the world, mainly in western countries. Moreover, research shows that loneliness tends to be experienced more severely by young adults than other age groups (Rokach, 2000), which is the case of university students who face profound periods of loneliness when attending university in a new place (Diehl et al., 2018). Digital technology, especially mental health apps (MHapps), have been viewed as promising solutions to address this distress in universities, however, little evidence on this topic reveals uncertainty around how these resources impact individual well-being. Therefore, this research proposed to investigate how the gamified social mobile app Noneliness reduced loneliness rates and other associated mental health issues of students from a German university. As little work has focused on digital apps targeting loneliness, this project also proposed to describe and discuss the app’s design and development processes. A multimethod approach was adopted: literature review on high-efficacy MHapps design, gamification for mental health and loneliness interventions; User Experience Design and Human-centered Computing. Evaluations occurred according to the app’s development iterations, which assessed four versions (from prototype to Beta) through quantitative and qualitative studies with university students. The main results obtained regarding the design aspects were: users' preference for minimalistic interfaces; importance in maintaining privacy and establishing trust among users; students' willingness to use an online support space for emotional and educational support. Most used features were those related to group discussions, private chats and university social events. Preferred gamification elements were those that provided positive reinforcement to motivate social interactions (e.g. Points, Levels and Achievements). Results of a pilot randomized controlled trial with university students (N = 12), showed no statistically significant interactions in reducing loneliness among experimental group members (n = 7, x² = 3.500, p-value = 0.477, Cramer’s V = 0.27) who made continued use of the app for six weeks. On the other hand, the app showed effects of moderate magnitude on loneliness reduction in this group. The app also demonstrated relatively strong magnitude effects on other associated variables, such as depression and stress in the experimental group. In addition to motivating the conduct of further studies with larger samples, the findings point to a potential app effectiveness not only to reduce loneliness, but also other variables that may be associated with the distress.
This study aimed to compare a simplified calculation of the knee abduction moment with the traditional inverse dynamics calculation when athletes perform fake-cut maneuvers with different complexities. In the simplified calculation, we multiply the force vector with its lever arm to the knee, projected onto the local coordinate system of the proximal thigh, hence neglecting the inertial contributions from distal segments. We found very strong ranking consistency using Spearman’s rank correlation coefficient when using the simplified method compared to the traditional calculation. Independent of the tasks, the simplified method resulted in higher moments than the inverse dynamics. This was caused by ignoring the moment caused by segment linear acceleration generating a counteracting moment by about 7%. An alternative to the complex calculations of inverse dynamics can be used to investigate the contributions of the GRF magnitude and its lever arm to the knee.
The purpose of this study was to 1) compare knee joint kinematics and kinetics of fake-and-cut tasks of varying complexity in 51 female handball players and 2) present a case study of one athlete who ruptured her ACL three weeks post data collection. External knee joint moments and knee joint angles in all planes at the instance of the peak external knee abduction moment (KAM) as well as moment and angle time curves were analyzed. Peak KAMs and knee internal rotation moments were substantially higher than published values obtained during simple change-of-direction tasks and, along with flexion angles, differed significantly between the tasks. Introducing a ball reception and a static defender increased joint loads while they partially decreased again when anticipation was lacking. Our results suggest to use game-specific assessments of injury risk while complexity levels do not directly increase knee loading. Extreme values of several risk factors for a post-test injured athlete highlight the need and usefulness of appropriate screenings.
When people with hearing loss are provided with different devices in each ear, these devices usually have different processing latencies. This leads to static temporal offsets between both ears in the order of several milliseconds. This thesis measured effects of such offsets in stimulation timing on mechanisms of binaural hearing, such as sound localization and speech understanding in noise in hearing-impaired and normal-hearing listeners.
Objective: To identify and evaluate the evidence of the most relevant running-related risk factors (RRRFs) for running-related overuse injuries (ROIs) and to suggest future research directions.
Design: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236832)
Data sources: Pubmed. Connected Papers. The search was performed in February 2021.
Eligibility criteria: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic RRRF. An RRRF needed to be identified in at least one prospective or two retrospective studies.
Results: Sixty-two articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some RRRFs appeared for several ROIs, most RRRFs were specific for a particular ROI. The biomechanical measurements performed in many studies would have allowed for consideration of many more RRRFs than have been reported, highlighting a potential for more effective data usage in the future.
Conclusion: This study offers a comprehensive overview of RRRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. Future work should use macroscopic (big data) approaches involving long-term data collections in the real world and microscopic approaches involving precise stress calculations using recent developments in biomechanical modelling. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
New frontiers of supraventricular tachycardia and atrial flutter evaluation and catheter ablation
(2012)
Radiofrequency catheter ablation (RFCA) has revolutionized treatment for tachyarrhythmias and has become first-line therapy for some tachycardias. Although developed in the 1980s and widely applied in the 1990s, the technique is still in development. Transesophageal atrial pacing (TAP) can used for initiation and termination of supraventricular tachycardia (SVT).
Methods: The paroxysmal SVT include a wide spectrum of disorders including, in descending order of frequency, atrial flutter, atrioventricular (AV) nodal reentry, Wolff-Parkinson-White syndrome, and atrial tachycardia. While not life-threatening in most cases, they may cause important symptoms, such as palpitations, chest discomfort, breathlessness, anxiety, and syncope, which significantly impair quality of life. Medical therapy has variable efficacy, and most patients are not rendered free of symptoms. Research over the past several decades has revealed fundamental mechanisms involved in the initiation and maintenance of all of these arrhythmias. Knowledge of mechanisms has in turn led to highly effective surgical and catheter-based treatments. The supraventricular arrhythmias and their treatment are described in this report. SVT initiation was analysed with programmed TAP in 49 patients with palpitations (age 47 ± 17 years, 24 females, 25 males).
Results: In comparison to antiarrhythmic drug therapy the radiofrequency catheter ablation in patients suffering from atrial flutter, atrioventricular nodal reentry, atrioventricular reentry and atrial tachycardia is the better choice in most cases. TAP SVT initiation was possible in 23 patients before RFCA. Atrial cycle length of SVT was 320 ± 59 ms. We initiated AV nodal reentrant tachycardia (AVNRT, n=15), atrial tachycardia (AT, n=6) and AV reentrant tachycardia with Kent pathway conduction (AVRT, n=2) before RFCA.
Conclusions: Radiofrequency catheter ablation is a successful and safe method to cure most patients with paroxysmal supraventricular tachycardias. TAP allowed initiation and termination of SVT especially in outpatients.
Whiplash injury
(2012)
Home Automation, Smart Metering, reduction of energy consumption for climate preservation – those buzz words are flooding the daily press.The European Directive 2006/32/EC (Energy-Use Efficiency and Energy Services) commits its members to reduce their energy consumption about nine percent from 1996 to 2015, and supports smart metering and the need of new developments for encouraging energy efficiency and CO² reduction in households and commercial buildings. The European countries have started different projects to achieve this goal. Also outside Europe, smart metering gains interest, for energy savings and better distribution network control.