Kardiologische Rehabilitation mit strukturierter Schulung bei Herzinsuffizienz: Akzeptanz bei Patienten und Veränderungen in Krankheitswissen und Wohlbefinden

Hintergrund und Fragestellung: Herzinsuffizienz ist ein häufiges klinisches Syndrom mit wachsender Bedeutung und schlechter Prognose. Patientenschulung ist ein zentraler Bestandteil der medizinischen Rehabilitation mit dem Ziel die Folgen chronischer Krankheiten durch gezielte Förderung von Krankheitskompetenz und Selbstmanagement zu verringern und die Lebensqualität von Patienten zu verbessern. Im Rahmen der vorliegenden explorativen Untersuchung wird ein neu entwickeltes Patientenschulungsprogramm für Herzinsuffizienz vorgestellt und die direkte Bewertung des Programms durch Patienten, die Veränderungen des krankheitsbezogenen Wissens, die gesundheits- und krankheitsbezogene Lebensqualität, sowie die psychische Symptombelastung im Verlauf erfasst. Methode: 64 Patienten (79,7% Männer) nahmen im Rahmen einer kardiologischen Rehabilitation an einer kompetenz-fokussierenden Schulung für Herzinsuffizienzpatienten teil. Die Patienten füllten zu Beginn, am Ende sowie sechs Monate nach der Rehabilitation Selbstbeurteilungsfragebögen zum psychischen Wohlbefinden und zur Lebenszufriedenheit, einen auf die Schulungsinhalte bezogenen Wissenstest und einen Evaluationsfragebogen aus. Ergebnisse: Die Bewertung des Schulungsprogramms durch die Teilnehmer war sehr gut. Wissen und Lebensqualität waren am Ende und sechs Monate nach der Rehabilitation signifikant gestiegen, die psychische Symptombelastung (Ängstlichkeit und Depressivität) reduziert. Schlussfolgerung: Während einer kardiologischen Rehabilitation erfährt ein strukturiertes Schulungsprogramm für Patienten mit Herzinsuffizienz eine hohe Akzeptanz seitens der Patienten. Die Patienten erfahren eine Verbesserung ihres Wissens über die Erkrankung, eine Reduktion von Angst- und Depressivitätserleben und eine Verbesserung ihrer Lebensqualität. Die Indikation für eine Schulung muss insbesondere bei Patienten mit Angstneigung sorgfältig abgeklärt werden

Bibliotherapy on coping with illness improves health literacy but not heart-related anxiety of patients in cardiological rehabilitation

Information of patients about their illness is necessary for patient empowerment and coping with illness. This can be done by written material, i.e. bibliotherapy [1-6]. Scientific data suggest that bibliotherapy can help patients to better understand their illness, improve their health behaviour, and reduce anxiety [2, 3, 7]. The objective of the present study is to investigate in a randomized controlled trial the effects of bibliotherapy on illness-related knowledge, i.e. health literacy, and on heart-related anxiety in cardiology patients

Using endogenous saccades to characterize fatigue in multiple sclerosis

Purpose Multiple Sclerosis (MS) is likely to cause dysfunction of neural circuits between brain regions increasing brain working load or a subjective overestimation of such working load leading to fatigue symptoms. The aim of this study was to investigate if saccades can reveal the effect of fatigue in patients with MS. Methods Patients diagnosed with MS (EDSS<=3) and age matched controls were recruited. Eye movements were monitored using an infrared eyetracker. Each participant performed 40 trials in an endogenous generated saccade paradigm (valid and invalid trials). The fatigue severity scale (FSS) was used to assess the severity of fatigue. FSS scores were used to define two subgroups, the MS fatigue group (score above normal range) and the MS non-fatigue. Differences between groups were tested using linear mixed models. Results Thirty-one MS patients and equal number of controls participated in this study. FSS scores were above the normal range in 11 patients. Differences in saccade latency were found according to group (p<0.001) and trial validity (p=0.023). Differences were 16.9 ms, between MS fatigue and MS non-fatigue, 15.5 ms between MS fatigue and control. The mean difference between valid and invalid trials was 7.5 ms. Differences in saccade peak velocity were found according to group (p<0.001), the difference between MS fatigue and control was 22.3°/s and between MS fatigue and non-fatigue was 12.3°/s. Group was a statistically significant predictor for amplitude (p<0.001). FSS scores were correlated with peak velocity (p=0.028) and amplitude (p=0.019). Conclusion Consistent with the initial hypothesis, our study revealed altered saccade latency, peak velocity and amplitude in patients with fatigue symptoms. Eye movement testing can complement the standard inventories when investigating fatigue because they do not share similar limitations. Our findings contribute to the understanding of functional changes induced by MS and might be useful for clinical trials and treatment decisions.We would like to acknowledge that part of this work has been presented at 3rd International Porto Congress of Multiple Sclerosis, February 27–28, 2015, Porto, Portugal and ECEM 2015 | XVIII. European Conference on Eye Movements, August 16–21, 2015, Viena, Austria. We thank the Multiple Sclerosis Association “Todos com a Esclerose Multiple (TEM)” and the Clinical and Academic Centre (CAA-Hospital de Braga) for their support financial support and for providing facilities for data collection, respectively. We also acknowledge: i) Carla Sofia for recruiting all the MS participants and most of the controls, ii) Two anonymous reviewers for their opinion about an early version of this manuscript and iii) Liz Pearce for proofreading the manuscript. Vision Rehabilitation Lab. receives founding from Shamir Portugal and from grant PTDC/DTP-EPI/0412/2012, Fundação para a Ciência e a Tecnologia, co-financiado pelo FEDER através do COMPETE.info:eu-repo/semantics/publishedVersio

Modeling growth, lipid accumulation and lipid turnover in submerged batch cultures of Umbelopsis isabellina

The production of lipids by oleaginous yeast and fungi becomes more important because these lipids can be used for biodiesel production. To understand the process of lipid production better, we developed a model for growth, lipid production and lipid turnover in submerged batch fermentation. This model describes three subsequent phases: exponential growth when both a C-source and an N-source are available, carbohydrate and lipid production when the N-source is exhausted and turnover of accumulated lipids when the C-source is exhausted. The model was validated with submerged batch cultures of the fungus Umbelopsis isabellina (formerly known as Mortierella isabellina) with two different initial C/N-ratios. Comparison with chemostat cultures with the same strain showed a significant difference in lipid production: in batch cultures, the initial specific lipid production rate was almost four times higher than in chemostat cultures but it decreased exponentially in time, while the maximum specific lipid production rate in chemostat cultures was independent of residence time. This indicates that different mechanisms for lipid production are active in batch and chemostat cultures. The model could also describe data for submerged batch cultures from literature well

Tumor-specific uptake of fluorescent bevacizumab-IRDye800CW microdosing in patients with primary breast cancer:a phase I feasibility study

PURPOSE: to provide proof of principle of safety, breast tumor-specific uptake and positive tumor margin assessment of the systemically administered near-infrared fluorescent (NIRF) tracer bevacizumab-IRDye800CW targeting vascular endothelial growth factor (VEGF)-A in breast cancer patients. EXPERIMENTAL DESIGN: Twenty patients with primary invasive breast cancer eligible for primary surgery received 4.5 mg bevacizumab-IRDye800CW as intravenous bolus injection. Safety aspects were assessed as well as tracer uptake and tumor delineation during surgery and ex vivo in surgical specimens using an optical imaging system. Ex vivo multiplexed histopathology analyses were performed for evaluation of biodistribution of tracer uptake and co-registration of tumor tissue and healthy tissue. RESULTS: None of the patients experienced adverse events. Tracer levels in primary tumor tissue were higher compared to those in the tumor margin (P < 0.05) and healthy tissue (P < 0.0001). VEGF-A tumor levels also correlated with tracer levels (r = 0.63, P < 0.0002). All but one tumor showed specific tracer uptake. Two out of 20 surgically excised lumps contained microscopic positive margins detected ex vivo by fluorescent macro- and microscopy and confirmed at the cellular level. CONCLUSIONS: Our study shows that systemic administration of the bevacizumab-IRDye800CW tracer is safe for breast cancer guidance and confirms tumor and tumor-margin uptake as evaluated by a systematic validation methodology. The findings are a step towards a phase II dose-finding study aimed at in vivo margin assessment and point to a novel drug assessment tool that provides a detailed picture of drug distribution in tumor tissue

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Storytelling in der Politik : erzählen und überzeugen

Diese Arbeit stellt fächerübergreifend dar, weshalb die Methode des Storytelling derart erfolgreich ist. Zudem wird auch dargelegt, wie jene Methode als Analyseinstrument genutzt werden kann. Im Folgenden wird auf Sonderformen (Power of Persuasion) eingegangen und die Anwedung in der Politik anhand von konkreten Beispielen betrachtet.Johannes GlatzAbweichender Titel laut Übersetzung der Verfasserin/des VerfassersUniversität Innsbruck, Masterarbeit, 2017(VLID)228984

Soziale Dienste entwickeln : Innovative Ansätze in Diakonie und Caritas. Ein Studien- und Arbeitsbuch

Soziale Dienstleistungen sind einem kontinuierlichen Wandel unterworfen. Angesichts neuer gesellschaftlicher Bedarfe und stetigen Konkurrenzdrucks im Sozialmarkt müssen Diakonie und Caritas Innovationsprozesse initiieren und neue Lösungen für soziale Bedarfslagen finden. Die Analyse von förderlichen Rahmenbedingungen und Trends sozialer Innovationen führt zu Fragen der Innovationsentwicklung: Welche Aspekte müssen im »Management« sozialer Innovationen beachtet werden? Wie können Ideen finanziert werden und welche Formen des Social Investment gibt es? Im zweiten Teil des Bandes werden fünf Praxis-Beispiele analysiert. Vertiefungshinweise und praktische Aufgaben leiten dazu an, dynamische Entwicklungen abseits traditioneller sozialstaatlicher Strukturen zu verstehen