Illness behaviour and influencing aspects of general practitioners in Germany and their use of the health care system: a qualitative study

Objectives The aim of this study was to explore aspects that play a role when general practitioners (GPs) become ill and thus gain a more comprehensive understanding of the overall illness behaviour of GPs and their use of the healthcare system. Setting Primary care practices in Thuringia, Germany. Participants Convenience sample of 16 GPs. Design Qualitative study design with semistructured interviews and content analysis. Results Using our approach of having participants report their own episodes of illness, we found that self-treatment was practised and accepted by all 16 participants. The widespread use of naturopathy and complementary methods seems to be a special feature of German GPs. Formal use of the healthcare system mainly took place through direct consultation with specialists. Our study revealed various aspects influencing the illness behaviour of the GPs and their use of the healthcare system. Some aspects also apply to lay patients, but it became clear how strongly illness behaviour is influenced by participants’ activities as physicians. Noteworthy and less described aspects are especially the influence of patients and practice staff, the influence of biographical and professional imprint and the attitudes and values of the physicians. Complex inter-relationships were found between illness behaviour and influencing aspects; these are subjected to a dynamic and recursive process. Conclusions The illness behaviour of German GPs seems to be comprehensively influenced by their activities as responsible healthcare providers. The ability to perceive and reflect in this regards should already be actively promoted in studies and further education. Further research is needed for a better understanding of the inter-relationships

The shape of RemiXXXes to come:Audio texture synthesis with time–frequency scattering

This article explains how to apply time--frequency scattering, a convolutional operator extracting modulations in the time--frequency domain at different rates and scales, to the re-synthesis and manipulation of audio textures. After implementing phase retrieval in the scattering network by gradient backpropagation, we introduce scale--rate DAFx, a class of audio transformations expressed in the domain of time--frequency scattering coefficients. One example of scale--rate DAFx is chirp rate inversion, which causes each sonic event to be locally reversed in time while leaving the arrow of time globally unchanged. Over the past two years, our work has led to the creation of four electroacoustic pieces: ``FAVN''; ``Modulator (Scattering Transform)''; ``Experimental Palimpsest''; ``Inspection''; and a remix of Lorenzo Senni's ``XAllegroX'', released by Warp Records on a vinyl entitled ``The Shape of RemiXXXes to Come''. The source code to reproduce experiments and figures is made freely available at: https://github.com/lostanlen/scattering.m. A companion website containing demos is at: https://lostanlen.com/pubs/dafx2019Comment: 8 pages, 3 figures. To appear in the proceedings of the International Conference on Digital Audio Effects (DAFX-19), Birmingham, U

Dark state experiments with ultracold, deeply-bound triplet molecules

We examine dark quantum superposition states of weakly bound Rb2 Feshbach molecules and tightly bound triplet Rb2 molecules in the rovibrational ground state, created by subjecting a pure sample of Feshbach molecules in an optical lattice to a bichromatic Raman laser field. We analyze both experimentally and theoretically the creation and dynamics of these dark states. Coherent wavepacket oscillations of deeply bound molecules in lattice sites, as observed in one of our previous experiments, are suppressed due to laser-induced phase locking of molecular levels. This can be understood as the appearance of a novel multilevel dark state. In addition, the experimental methods developed help to determine important properties of our coupled atom / laser system.Comment: 20 pages, 9 figure

Voice analysis for neurological disorder recognition – a systematic review and perspective on emerging trends

Quantifying neurological disorders from voice is a rapidly growing field of research and holds promise for unobtrusive and large-scale disorder monitoring. The data recording setup and data analysis pipelines are both crucial aspects to effectively obtain relevant information from participants. Therefore, we performed a systematic review to provide a high-level overview of practices across various neurological disorders and highlight emerging trends. PRISMA-based literature searches were conducted through PubMed, Web of Science, and IEEE Xplore to identify publications in which original (i.e., newly recorded) datasets were collected. Disorders of interest were psychiatric as well as neurodegenerative disorders, such as bipolar disorder, depression, and stress, as well as amyotrophic lateral sclerosis amyotrophic lateral sclerosis, Alzheimer's, and Parkinson's disease, and speech impairments (aphasia, dysarthria, and dysphonia). Of the 43 retrieved studies, Parkinson's disease is represented most prominently with 19 discovered datasets. Free speech and read speech tasks are most commonly used across disorders. Besides popular feature extraction toolkits, many studies utilise custom-built feature sets. Correlations of acoustic features with psychiatric and neurodegenerative disorders are presented. In terms of analysis, statistical analysis for significance of individual features is commonly used, as well as predictive modeling approaches, especially with support vector machines and a small number of artificial neural networks. An emerging trend and recommendation for future studies is to collect data in everyday life to facilitate longitudinal data collection and to capture the behavior of participants more naturally. Another emerging trend is to record additional modalities to voice, which can potentially increase analytical performance

Long Distance Transport of Ultracold Atoms using a 1D optical lattice

We study the horizontal transport of ultracold atoms over macroscopic distances of up to 20 cm with a moving 1D optical lattice. By using an optical Bessel beam to form the optical lattice, we can achieve nearly homogeneous trapping conditions over the full transport length, which is crucial in order to hold the atoms against gravity for such a wide range. Fast transport velocities of up to 6 m/s (corresponding to about 1100 photon recoils) and accelerations of up to 2600 m/s2 are reached. Even at high velocities the momentum of the atoms is precisely defined with an uncertainty of less than one photon recoil. This allows for construction of an atom catapult with high kinetic energy resolution, which might have applications in novel collision experiments.Comment: 15 pages, 8 figure

Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents

Scharpf F, Kyaruzi E, Landolt MA, Hecker T. Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents. European Journal of Psychotraumatology. 2019;10(1): 1676005.Background: Although the family constitutes the prime source of risk and resilience for the well-being of children growing up in adverse conditions, the mental health of children living in refugee camps has rarely been investigated in conjunction with their parents’ mental health. Objectives: To examine the prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among Burundian refugee children and their parents living in Tanzanian refugee camps and to identify patterns of comorbidity among children and their parents based on PTSD symptom levels and functional impairment. Methods: We recruited a representative sample of 230 children aged 7–15 years and both of their parents (n = 690) and conducted separate structured clinical interviews. Latent Class Analysis was applied to identify patterns of comorbidity. Results: Children and parents were exposed to multiple traumatic event types. In total, 5.7% of children fulfilled DSM-5 criteria for PTSD in the past month and 10.9% reported enhanced levels of other mental health problems. 42.6% indicated clinically significant functional impairment due to PTSD symptoms. PTSD prevalence was higher among mothers (32.6%) and fathers (29.1%). Latent Class Analysis (LCA) revealed a familial accumulation of PTSD symptoms as children with high symptom levels and impairment were likely to live in families with two traumatized parents. Conclusions: Although the number of children who need support for trauma-related mental health problems was relatively low, taking into account parental trauma could aid to identify at-risk children with elevated PTSD symptom levels and impairment even in the face of existing barriers to mental health care access for children in refugee camp settings (e.g. lack of targeted services, prioritization of managing daily stressors)

Treatment of Knee Dislocation With Primary Repair and Suture Augmentation: A Viable Solution.

BACKGROUND Different surgical techniques have been described for the treatment of knee dislocation (KD). Nonoperative approaches are frequently combined with surgical reconstruction using auto- or allograft. PURPOSE To evaluate the midterm results of primary surgical repair and suture augmentation to treat KD. STUDY DESIGN Case series; Level of evidence, 4. METHODS A total of 22 patients (5 women, 17 men; mean age, 45 ± 15 years) with KD were evaluated at a mean of 49 ± 16 months after surgical treatment that included primary repair and suture augmentation. Magnetic resonance imaging, stress radiographs, and outcome scores were obtained at the follow-up. Clinical examination including hop tests and force measurements for flexion and extension was performed. RESULTS The mean difference in pre- to postinjury Tegner scores was -2 ± 1. The outcome scores showed mean values of 84 ± 15 (Lysholm), 73 ± 15 (International Knee Documentation Committee) and 65 ± 25 (Anterior Cruciate Ligament-Return to Sport after Injury scale). Compared with the uninjured knee, the range of motion of the injured knee was reduced by 21° ± 12°. Twelve patients felt fit enough to perform hop tests and showed a mean deficit of 7% ± 17%° compared with the uninjured leg. The mean force deficit was 19% ± 18% for extension and 8% ± 16% for flexion. Stress radiographs revealed an 11 ± 7-mm higher anteroposterior translation on the injured side. Four patients had secondary ligament reconstructions due to persistent instability and 7 underwent arthroscopic arthrolysis due to stiffness. A significant increase of osteoarthritis was found for the medial, lateral, and patellofemoral compartments (P = .007, .004, and .006, respectively). CONCLUSION Primary repair and suture augmentation of KD led to satisfactory clinical midterm results despite persistent radiological instability and a significant increase in osteoarthritis. This technique allows the return to activities of daily living without subjective instability in most nonathletic patients. Secondary ligament reconstructions should be performed if relevant instability persists to decrease the risk of secondary meniscal and cartilage damage