Digital health applications in rehabilitation: Adherence and motivation by gamification

Bei der Entwicklung Digitaler Gesundheitsanwendungen (DiGA) sind eine Reihe rechtlicher, finanzieller und qualitativer Rahmenbedingungen zu berücksichtigen. Hinzu kommen organisatorische und technische Anforderungen zur Einbindung einer DiGA in Versorgungsprozesse. In Rehabilitationsprozessen spielt die Therapieadhärenz der Patienten eine wesentliche Rolle. Wie bereits vergangene Studien gezeigt haben, können diese durch den Einsatz von Spiel-Design-Elementen gesteigert werden. Die Auswahl, Kombination und das Design einzelner Spiele-Komponenten wirkt jedoch oftmals unüberlegt. Das Ziel dieser Dissertation ist es, einen ganzheitlichen Ansatz zur Entwicklung und Verbesserung von DiGA für die Rehabilitation zum Zweck der Adhärenzsteigerung durch Gamification zu erstellen und in der Praxis zu erproben. Um den Realitätsbezug des Ansatzes zu sichern, wurde das Krankheitsbild der Schulterläsionen als Anwendungsbeispiel genutzt. In acht Ebenen erfolgte die systematische Entwicklung des GISMOR-Ansatzes – ‘Gamification Increasing Motivation for Rehabilitation’. GISMOR unterstützt sowohl bei der Identifikation potentieller Adhärenzfaktoren (Patientenebene) als auch bei der adäquaten auf die Zielgruppe ausgerichteten Auswahl, Kombination und Umsetzung von Spiel-Design-Elementen (Gamificationebene). Dabei legt GISMOR besonderen Wert auf die Interaktion zwischen der DiGA und dem Patienten und stellt damit nicht nur die interaktive und visuelle Gestaltung des User Interface in den Vordergrund, sondern auch die resultierende User Experience (Interaktionsebene). Darüber hinaus gibt GISMOR den rechtlichen, finanziellen und qualitativen Rahmen für die Umsetzung abrechnungsfähiger DiGA vor (Dienstleistungsebene). Für den erfolgreichen Einsatz von DiGA liefert GISMOR weiterhin Anhaltspunkte zur Einbindung dieser in Rehabilitationsprozesse (Prozessebene) sowie zur Integration in transinstitutionelle Informationssystemarchitekturen (Informationssystemebene). Über den Anwendungsleitfaden zu GISMOR wird der entwickelte Ansatz schließlich in der Praxis einsetzbar. Als eigenständiges Dokument dient der Anwendungsleitfaden Softwareentwicklern, Medizininformatikern und Gesundheitsversorgern als Handlungshilfe zur Entwicklung und Verbesserung von DiGA sowie Medizinischen Assistenzsystemen. Am Beispiel des Telerehabilitationssystems AGT-Reha konnte dabei gezeigt werden, dass GISMOR sowohl für die Analyse als auch Ausarbeitung konkreter Maßnahmen zur Verbesserung einer DiGA geeignet ist.A number of legal, financial, and qualitative constraints must be considered in developing operational and billable digital health applications (DiGA). Furthermore, there are organizational and technical requirements for integrating DiGAs into care processes. In rehabilitation processes, patients' motivation and adherence are essential factors as well. Past studies have already shown that these can be increased through the use of game design elements. However, the selection, combination, and design of game components often seems rash. The objective of this thesis is to design and evaluate a holistic approach for developing and improving DiGAs in rehabilitation for the purpose of increasing motivation and adherence through gamification. Shoulder lesions were used as a consistent application example. The systematic development of GISMOR – ‘Gamification Increasing Motivation for Rehabilitation’ – was done in eight tiers. GISMOR supports both the identification of potential adherence factors (patient tier) and the adequate selection, combination, and implementation of game design elements aligned with the target group (gamification tier). GISMOR emphasizes the interaction between a DiGA and the patient, thus focusing not only on the interactive and visual design of the user interface, but also on the resulting user experience (interaction tier). In addition, GISMOR provides a legal, financial and qualitative framework for the implementation of billable DiGAs (service tier). For the successful use of DiGAs, GISMOR continues to provide guidance on how to embed them in rehabilitation processes (process tier) and how to integrate them into transinstitutional information system architectures (information system tier). By means of the GISMOR guide for use, the developed approach will finally be applicable in practice. As a stand-alone document, the User Guide serves software developers, medical informaticians, and healthcare providers as a reference for action in the development and improvement of DiGAs and Medical Assistance Systems. Using the telerehabilitation system AGT-Reha as an example, it could be shown that GISMOR is suitable for both the analysis and the development of concrete measures for the improvement of a DiGA

Safety and Reliability - Safe Societies in a Changing World

The contributions cover a wide range of methodologies and application areas for safety and reliability that contribute to safe societies in a changing world. These methodologies and applications include: - foundations of risk and reliability assessment and management - mathematical methods in reliability and safety - risk assessment - risk management - system reliability - uncertainty analysis - digitalization and big data - prognostics and system health management - occupational safety - accident and incident modeling - maintenance modeling and applications - simulation for safety and reliability analysis - dynamic risk and barrier management - organizational factors and safety culture - human factors and human reliability - resilience engineering - structural reliability - natural hazards - security - economic analysis in risk managemen

Review of particle physics

The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,283 new measurements from 899 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as heavy neutrinos, supersymmetric and technicolor particles, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as Supersymmetry, Extra Dimensions, Particle Detectors, Probability, and Statistics. Among the 112 reviews are many that are new or heavily revised including those on: Dark Energy, Higgs Boson Physics, Electroweak Model, Neutrino Cross Section Measurements, Monte Carlo Neutrino Generators, Top Quark, Dark Matter, Dynamical Electroweak Symmetry Breaking, Accelerator Physics of Colliders, High-Energy Collider Parameters, Big Bang Nucleosynthesis, Astrophysical Constants and Cosmological Parameters. A booklet is available containing the Summary Tables and abbreviated versions of some of the other sections of this full Review. All tables, listings, and reviews (and errata) are also available on the Particle Data Group website: http://pdg.Ibi.gov