Sacred Scripture / Sacred Space

Thirteen papers on different subjects, focussing on writings and inscriptions in medieval art, explore the faculty of writing to create and determine spaces and to generate the sacred by the display of holy scripture. The subjects range from book illumination over wall painting, mosaics, sculpture, and church interiors to inscriptions on portals and façades

Early community-based family practice elective positively influences medical students’ career considerations – a Pre-post-comparison

BACKGROUND: Demographic change and recruitment problems in family practice are increasingly threatening an adequate primary care workforce in many countries. Thus, it is important to attract young physicians to the field. The purpose of the present study was to examine the effect of an early community-based 28-h family practice elective with one-to-one mentoring on medical students’ consideration of family practice as a career option, their interest in working office-based, and several perceptions with regard to specific aspects of a family physician’s work. METHODS: First- and second-year medical students completed questionnaires before and after a short community-based family practice elective, consisting of a preparatory course and a community-based practical experience with one-to-one mentoring by trained family physicians. RESULTS: We found a significantly higher rate of students favoring family practice as a career option after the elective (32.7% vs. 26.0%, p = 0.039). Furthermore, the ranking of family practice among other considered career options improved (p = 0.002). Considerations to work office-based in the future did not change significantly. Perceptions regarding a family physician’s job changed positively with regard to the possibility of long-term doctor-patient relationships and treatment of complex disease patterns. The majority of the students described identification with the respective family physician tutor as a professional role model and an increased interest in the specialty. CONCLUSIONS: Our results indicate that a short community-based family practice elective early in medical education may positively influence medical students’ considerations of a career in family practice. Furthermore, perceptions regarding the specialty with significant impact on its attractiveness may be positively adjusted. Further research is needed to evaluate the influence of different components of a family practice curriculum on the de facto career decisions of young physicians after graduation

Identifying patients with psychosocial problems in general practice: a scoping review protocol

Introduction: Psychosocial problems (PSPs) are common issues associated with negative health outcomes. Since general practitioners are the first point of contact for any health-related concern, understanding their options to recognise patients with PSPs plays an important role as it is essential for early intervention and can prevent serious conditions. The objective of our scoping review is to map published evidence on the usage of instruments to identify patients with PSPs in general practice. Methods and analysis: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute Reviewer’s Manual on scoping reviews. A systematic search of four electronic databases (Medline (Ovid), Web of Science Core Collection, PsycInfo, Cochrane Library) will be conducted for quantitative and qualitative studies published in English, Spanish, French and German. Main study characteristics as well as information on identification instruments will be extracted and visualised in structured tables to map the available evidence. The protocol has been registered with Open Science Framework, https://osfio/c2m6z. Ethics and dissemination: This study does not require ethical approval as we will not collect personal data. Dissemination will consist of publications, presentations and other knowledge translation activities

Effective behavior change techniques in digital health interventions targeting non-communicable diseases: an umbrella review

Background: Despite an abundance of digital health interventions (DHIs) targeting the prevention and management of common non-communicable diseases (NCDs), it is unclear what specific components make an intervention effective in changing human behavior.Purpose: The aim of this umbrella review was to identify the most effective behavior change techniques (BCTs) in DHIs that address the most common NCDs. Methods: Five electronic databases were searched for articles published in English between 1st January 2007 and 24th January 2021. Studies were included if they were systematic reviews or meta-analyses of e- or mHealth interventions targeting the modification of one or more NCD-related risk factors in adults. Study quality was assessed using AMSTAR 2. Sixty-one articles, spanning 10 health domains and comprising over half a million individual participants, were included in the review. Results: DHIs are favorably associated with improved health outcomes for patients with cardiovascular disease, cancer, type 2 diabetes, and asthma, and health-related behaviors including physical activity, sedentary behavior, diet, weight management, medication adherence, and abstinence from substance use. There was strong evidence to suggest education, communication with a professional, tailored reminders, goals and planning, feedback and monitoring, and personalization components increase the effectiveness of DHIs targeting NCDs and lifestyle behaviors. Conclusions: Common BCTs across health domains, such as ‘goals and planning’, increase DHI effectiveness and should be prioritized for inclusion within future interventions. These findings are critical for the future development and upscaling of DHIs and should inform best practice guidelines

Effective Behavior Change Techniques in Digital Health Interventions for the Prevention or Management of Noncommunicable Diseases: An Umbrella Review

Background Despite an abundance of digital health interventions (DHIs) targeting the prevention and management of noncommunicable diseases (NCDs), it is unclear what specific components make a DHI effective. Purpose This narrative umbrella review aimed to identify the most effective behavior change techniques (BCTs) in DHIs that address the prevention or management of NCDs. Methods Five electronic databases were searched for articles published in English between January 2007 and December 2022. Studies were included if they were systematic reviews or meta-analyses of DHIs targeting the modification of one or more NCD-related risk factors in adults. BCTs were coded using the Behavior Change Technique Taxonomy v1. Study quality was assessed using AMSTAR 2. Results Eighty-five articles, spanning 12 health domains and comprising over 865,000 individual participants, were included in the review. We found evidence that DHIs are effective in improving health outcomes for patients with cardiovascular disease, cancer, type 2 diabetes, and asthma, and health-related behaviors including physical activity, sedentary behavior, diet, weight management, medication adherence, and abstinence from substance use. There was strong evidence to suggest that credible source, social support, prompts and cues, graded tasks, goals and planning, feedback and monitoring, human coaching and personalization components increase the effectiveness of DHIs targeting the prevention and management of NCDs. Conclusions This review identifies the most common and effective BCTs used in DHIs, which warrant prioritization for integration into future interventions. These findings are critical for the future development and upscaling of DHIs and should inform best practice guidelines

Exploring the potential of mobile health interventions to address behavioural risk factors for the prevention of non-communicable diseases in Asian populations: a qualitative study

Background Changing lifestyle patterns over the last decades have seen growing numbers of people in Asia affected by non-communicable diseases and common mental health disorders, including diabetes, cancer, and/or depression. Interventions targeting healthy lifestyle behaviours through mobile technologies, including new approaches such as chatbots, may be an effective, low-cost approach to prevent these conditions. To ensure uptake and engagement with mobile health interventions, however, it is essential to understand the end-users’ perspectives on using such interventions. The aim of this study was to explore perceptions, barriers, and facilitators to the use of mobile health interventions for lifestyle behaviour change in Singapore. Methods Six virtual focus group discussions were conducted with a total of 34 participants (mean ± SD; aged 45 ± 3.6 years; 64.7% females). Focus group recordings were transcribed verbatim and analysed using an inductive thematic analysis approach, followed by deductive mapping according to perceptions, barriers, facilitators, mixed factors, or strategies. Results Five themes were identified: (i) holistic wellbeing is central to healthy living (i.e., the importance of both physical and mental health); (ii) encouraging uptake of a mobile health intervention is influenced by factors such as incentives and government backing; (iii) trying out a mobile health intervention is one thing, sticking to it long term is another and there are key factors, such as personalisation and ease of use that influence sustained engagement with mobile health interventions; (iv) perceptions of chatbots as a tool to support healthy lifestyle behaviour are influenced by previous negative experiences with chatbots, which might hamper uptake; and (v) sharing health-related data is OK, but with conditions such as clarity on who will have access to the data, how it will be stored, and for what purpose it will be used. Conclusions Findings highlight several factors that are relevant for the development and implementation of mobile health interventions in Singapore and other Asian countries. Recommendations include: (i) targeting holistic wellbeing, (ii) tailoring content to address environment-specific barriers, (iii) partnering with government and/or local (non-profit) institutions in the development and/or promotion of mobile health interventions, (iv) managing expectations regarding the use of incentives, and (iv) identifying potential alternatives or complementary approaches to the use of chatbots, particularly for mental health

Development of a network of genetic reserves for wild celery in Germany (GE-Sell)

Die Technik des genetischen Erhaltungsgebiets ist ein anwendungsbereites Verfahren zur In-situ-Erhaltung von wildlebenden Verwandten unserer Kulturpflanzen. Bei dem Verfahren wird die dynamische Erhaltung von Populationen, die in ihren natürlichen Lebensräumen Evolutionsprozessen ausgesetzt sind, mit der statischen Erhaltung pflanzengenetischer Ressourcen in Genbanken kombiniert und somit die nachhaltige Nutzung dieser Arten ermöglicht. Im Modell- und Demonstrationsvorhaben "Genetische Erhaltungsgebiete für Wildselleriearten (Apium und Helosciadium) als Bestandteil eines Netzwerks genetischer Erhaltungsgebiete in Deutschland" (GESell) wurden wissenschaftliche und organisatorische Fragestellungen zur Umsetzung dieser Technik bearbeitet. Ziel des Projekts war die modellhafte Einrichtung von 45 genetischen Erhaltungsgebieten (GenEG) für Wildselleriearten und der Aufbau eines bundesweiten Netzwerks aus lokalen Akteuren. Zur Identifizierung der GenEG wurde das monografische Verfahren angewendet. Für die vier in Deutschland vorkommenden Wildselleriearten wurden zum Projektstart im Jahr 2015 aus 2400 Fundortdaten 322 Standorte für Präsenzkontrollen ausgewählt. Im Anschluss wurden für rund 100 möglichst vitale und ungefährdete Vorkommen, die sich über verschiedene Naturräume und Habitate verteilen, genetische Diversitätsanalysen durchgeführt. Anhand der Kartierungs- und Analyseergebnisse wählte das Projektteam zwischen 11 und 15 Vorkommen pro Art aus, die insgesamt die innerartliche Vielfalt der jeweiligen Arten bestmöglich repräsentieren. Für diese Vorkommen wurden die Einrichtung und ein langfristiges Management der GenEG in Zusammenarbeit mit lokalen Akteuren angestrebt. Bis zum April 2020 wurden bereits 15 GenEG eingerichtet.The genetic reserve conservation technique is a ready-to-use procedure for in situ conservation of crop wild relatives. The approach combines the dynamic conservation of populations exposed to evolutionary processes in their natural habitats with the static conservation of plant genetic resources in gene banks, thus enabling the sustainable use of these species. In the model and demonstration project "Genetic reserves for wild celery species (Apium and Helosciadium) as part of a network of genetic reserves in Germany" (GE-Sell) scientific and organisational aspects of the implementation of genetic reserves were investigated. The aim of the project was the establishment of 45 genetic reserves for wild celery species and the establishment of a nationwide network of local stakeholders. The monographic approach was used to identify the genetic reserves. For the four wild celery species occurring in Germany, around 350 occurrences were selected from 2400 known sites for the verification of these occurrences at the project start in 2015. Thereafter, genetic diversity analyses were carried out for approximately 100 occurrences that are as vital as possible, non-endangered and distributed over various ecogeographic regions and habitat types. Based on the survey and analysis results, the project team selected between 11 and 15 occurrences per species, which together represent the intra-species diversity of the respective species best. For these occurrences, the project team aimed at the establishment and long-term management of the genetic reserves in cooperation with local stakeholders. By April 2020, 15 genetic reserves had already been established

Marathon-Induced Cardiac Strain as Model for the Evaluation of Diagnostic microRNAs for Acute Myocardial Infarction

Background: The current gold standard biomarker for myocardial infarction (MI), cardiac troponin (cTn), is recognized for its high sensitivity and organ specificity; however, it lacks diagnostic specificity. Numerous studies have introduced circulating microRNAs as potential biomarkers for MI. This study investigates the MI-specificity of these serum microRNAs by investigating myocardial stress/injury due to strenuous exercise. Methods: MicroRNA biomarkers were retrieved by compre hensive review of 109 publications on diagnostic serum microRNAs for MI. MicroRNA levels were first measured by next-generation sequencing in pooled sera from runners (n = 46) before and after conducting a full competitive marathon. Hereafter, reverse transcription quantitative real-time PCR (qPCR) of 10 selected serum microRNAs in 210 marathon runners was performed (>10,000 qPCR measurements). Results: 27 potential diagnostic microRNA for MI were retrieved by the literature review. Eight microRNAs (miR-1-3p, miR-21-5p, miR-26a-5p, miR-122-5p, miR-133a-3p, miR-142-5p, miR-191-5p, miR-486-3p) showed positive correlations with cTnT in marathon runners, whereas two miRNAs (miR-134-5p and miR-499a-5p) showed no correlations. Upregulation of miR-133a-3p (p = 0.03) and miR-142-5p (p = 0.01) went along with elevated cTnT after marathon. Conclusion: Some MI-associated microRNAs (e.g., miR-133a-3p and miR-142-5p) have similar kinetics under strenuous exercise and MI as compared to cTnT, which suggests that their diagnostic specificity could be lim ited. In contrast, several MI-associated microRNAs (miR-26a-5p, miR-134-5p, miR-191-5p) showed different release behavior; hence, combining cTnT with these microRNAs within a multi-marker strategy may add diagnostic accuracy in MI