Zur Konstituierung von Gemeinschaft in einem Fantasy- und Rollenspielchatraum

Die vorliegende Arbeit beruht auf der Forschung in einem Mittelalterrollenspiel- und Fantasy-Chat im Internet, der "Taverne zum Wanderer". Die zentrale These dieser Arbeit lautet, daß sich im Internet Gemeinschaften bilden können, die in ihrer Intensität den Gemeinschaften des "wirklichen Lebens" in nichts nachstehen, sondern über ganz eigene Qualitäten verfügen, welche auf die Internetgemeinschaft wirken und diese festigen. Wie diese Gemeinschaften im Internet entstehen und was sie zusammenhält, soll im folgenden unter Einbeziehung der spezifischen Chatkommunikation, der Interaktionsrituale und der Sozialität der Gäste der Taverne zum Wanderer gezeigt werden. Die Arbeit gibt zunächst einen kurzen Überblick über die ethnologische und ethnographische Internetforschung. Des weiteren geht sie auf ethnologische Methoden zur Erforschung von Internetgemeinschaften und Ethnographie im Cyberspace ein. Einige allgemeine Gedanken über Gemeinschaft, Online-Communities und das Verhältnis von Virtualität und Realität sollen auf die Thematik hinführen, wobei neben modernen Definitionen von Online-Communities auch traditionelle Ansätze zur Gemeinschaft (Tönnies, Weber, Simmel) berücksichtigt werden. Das Kapitel über Cyberspace und Virtuelle Realitäten wird zeigen, daß es "den" Cyberspace eigentlich nicht gibt, und daß Virtuelle Realitäten bzw. Virtualität nicht allein auf das Internet beschränkt sind. Einen ersten Schwerpunkt bildet die "Taverne zum Wanderer" und ihre Gäste. Der Rollenspiel- und Phantasiechatraum "Taverne zum Wanderer" wird vorgestellt, und es wird erklärt, wie man in einem Chat agiert und kommuniziert. Die Begriffe "inplay" und "offplay" werden erläutert. Anhand der Analyse von Chatprotokollen wird die Frage geklärt, ob und warum ein Chat eine kommunikative Gattung darstellt, und inwieweit ein Chat eine Sonderstellung zwischen mündlicher und schriftlicher Kommunikation einnimmt. Abgeschlossen wird dieses Kapitel mit einem Vergleich von Chat mit Telephon und Chat mit Hörspiel. Ein weiteres großes Kapitel stellt die "Taverne zum Wanderer" als Online-Community vor. Es wird diskutiert, ob die gemeinhin gebräuchlichen Ausdrücke "Virtuelle Realität" im Gegensatz zum "Real Life" gerechtfertigt sind, oder ob nicht ein Umdenken im Sprachgebrauch, beruhend auf den Empfindungen und Erfahrungen der User, angebracht wäre, wobei besonders auf den Stellenwert von "Imagined Communities" eingegangen wird. Ein kurzer Abschnitt diskutiert die "Taverne zum Wanderer" als "Lineage". In Anlehnung an Appadurais "scapes" wird anschließend den Begriff "Cyberscape" eingeführt, der den Möglichkeiten zur Imagination im fluiden Medium Cyberspace gerecht wird. Anhand von Beispielen aus protokollierten Chatlogs werden abschließend Machtstrukturen und Machtverhältnisse in der "Taverne zum Wanderer" gezeigt, wobei das Lösen von Konflikten innerhalb der Chattergemeinschaft gesondert behandelt wird. Die letzten beiden großen Kapitel der Arbeit widmen sich dem Aspekt der Theatralität im Internet: Die "Taverne zum Wanderer" wird zum Schauplatz des Geschehens, dessen Akteure auf vielfältige Weise versuchen, Dreidimensionalität in virtuelle Welten zu zaubern. Ferner soll die "Taverne zum Wanderer" als Ort der Inszenierung betrachtet werden, an dem ludische Performanzen aufgeführt und Spielewelten erzeugt werden. Anhand einer bestimmten Chatepisode sollen schließlich die verschiedenen Frames gezeigt werden, die während einer Chatsitzung in einer solchen Spielewelt entstehen können

A pattern of unspecific somatic symptoms as long-term premonitory signs of type 2 diabetes: findings from the population-based MONICA/KORA cohort study, 1984-2009

BACKGROUND: Unspecific symptoms often proceed a serious chronic disease condition long before the onset of the disease. The role of an unspecific premonitory symptom (UPMS) pattern as premonitory signs of subsequent type 2 diabetes mellitus (T2DM) diagnosis independent of established cardio-metabolic risk factors is unclear and therefore was examined in the present study. METHODS: The study population consisted of 10,566 participants aged 25-74 years at baseline drawn from the population-based MONICA/KORA Cohort Study conducted in 1984-2009 in the Augsburg region (Germany). Unspecific premonitory symptoms were assessed following the Somatic Symptom Scale-8 (SSS-8). The impact of the score on T2DM risk within a mean follow-up time of 16 years was estimated by Cox regression. RESULTS: Within follow-up, 974 newly diagnosed T2DM cases were observed. The risk for T2DM increased by a hazard ratio (HR) of 1.03 (95% CI 1.01-1.04, p value < 0.001) for a one unit increase of the UPMS score in a Cox model adjusted for age, sex and survey. Additional adjustment for cardio-metabolic risk factors attenuated this effect (HR = 1.02) but significance remained (p value = 0.01). CONCLUSIONS: Suffering from an elevated burden of unspecific somatic symptoms is associated with T2DM long before the onset and independent of established cardio-metabolic risk factors. Further research is needed to obtain insight in potential underlying pathophysiological mechanisms

Symptom trajectories in patients with panic disorder in a primary care intervention: Results from a randomized controlled trial (PARADISE)

This analysis aims to identify and characterize symptom trajectories in primary care patients with panic disorder with/without agoraphobia (PD/AG) who participated in a primary care team based training involving elements of cognitive behavioural therapy (CBT). Growth Mixture Modeling was used to identify different latent classes of change in patients with PD/AG (N = 176) who underwent treatment including CBT elements. We identified three patient classes with distinct similar trajectories. Class 1 (n = 58, mean age: 46.2 years +/- 13.4 years, 81% women) consisted of patients with an initially high symptom burden, but symptoms declined constantly over the intervention period. Symptoms of patients in class 2 (n = 89, mean age: 44.2 years +/- 14.5 years, 67.4% women) declined rapidly at the beginning, then patients went into a plateau-phase. The third class (n = 29, mean age: 47.0 years +/- 12.4 years, 65.5% women) was characterized by an unstable course and had the worse outcome. Our findings show that only a minority did not respond to the treatment. To identify this minority and refer to a specialist would help patients to get intensive care in time

Suicide Mortality in Comparison to Traffic Accidents and Homicides as Causes of Unnatural Death. An Analysis of 14,441 Cases in Germany in the Year 2010

Aim: To assess suicide mortality in comparison to traffic accidents and homicide deaths in Germany in the year 2010 and to compare years of life lost (YLL) due to these unnatural deaths. Methods: Mortality data were provided by the Federal Statistical Office giving death rates (related to 100,000 inhabitants) and proportions (related to 100 deaths of individuals) for suicide, traffic accidents and homicide as well as YLL data. Results: A total of 14,441 unnatural deaths (suicide, traffic accidents, homicide) were reported in 2010 in Germany. Of those, 10,021 subjects (69.4%) committed suicide, 3,942 (27.3%) died in traffic accidents, 478 (3.3%) were murdered. Suicide death rates were by far the highest, with rates for men (18.6) three times higher than for women (6.1). For both sexes, suicide rates increased with age, whereas suicide as a proportion of all causes of death was higher in younger age groups. In both sexes, suicide was the leading cause of YLL (men: 314 YLL, women: 90 YLL). Conclusions: Suicide is the leading cause of unnatural death and YLL. The sex- and age- specific patterns in suicide mortality call for different action plans to target high risk groups

Collecting evidence from distributed sources to evaluate railway suicide and trespass prevention measures

It can be difficult to select from available safety preventative measures, especially where there is limited evidence of effectiveness in different contexts. This paper describes application of a method to identify and evaluate wide-ranging preventative measures for rail suicide and trespass fatalities. Evidence from literature and industry sources was collated and reviewed in a two stage process to achieve consensus among experts on the likely effects of the measures and factors influencing their implementation. Multiple evaluation criteria were used to examine the measures from different perspectives. Fencing, awareness campaigns and different types of organisational initiatives were recommended for further testing. This is the first time evidence has been collected internationally across such a range of preventative measures. Commentary is provided on using this type of approach to select safety measures from a pool of prevention options, including how re-framing the scope of the exercise could identify alternative options for prevention. Practitioner summary: The findings give insight to how different measures work in different ways and how industry can consider this in strategic initiatives. The method could be used in future studies with different frames of reference (e.g. different timescales, level of ambition and safety context e.g. railway crossings or highway fatalities)

Behaviour patterns preceding a railway suicide: Explorative study of German Federal Police officers' experiences

<p>Abstract</p> <p>Background</p> <p>Constant high-level numbers of railway suicides indicate that prevention strategies against railway suicides are urgently needed. The main question of the present study was whether pre-crash railway suicide behaviour can be identified, using German Federal Police officers experience with suicidal events in railway related environments.</p> <p>Methods</p> <p>To collect information on pre-crash railway suicide behaviour, a questionnaire was used and made available on the German Federal Police intranet. A total of 202 subjects (mean age: 41 years, sex: 84.9% male) were included in the analysis. Multivariate logistic regression analyses were performed to predict the prevention of suicide (first model) or demand for counselling (second model) as outcomes. Sex, age, years of service, number of experienced suicides, suicides personally observed, information on suicides obtained from witnesses and finally either counselling/debriefing (first model) or whether officers had prevented a suicide (second model) were used as predictors.</p> <p>Results</p> <p>A considerable proportion of police officers reported behavioural patterns preceding a suicide. Half of them observed the dropping or leaving behind of personal belongings or the avoidance of eye contact, more than a third erratic gesture, mimic or movement. Erratic communication patterns and general confusion were each reported by about one quarter. One fifth indicated the influence of alcohol. Less frequently observed behaviour was aimlessly wandering (14.3%) and out of the ordinary clothing (4%). About one third of all railway suicide victims committed suicide in stations. Of those, 70% had chosen an eminent spot. The multivariate logistic regression model using prevented suicides as the outcome identified the number of suicides experienced, counselling/debriefing and having personally observed a suicide as variables with significant impact. The model using counselling/debriefing as the outcome identified age and having prevented a suicide as variables with a significant association.</p> <p>Conclusions</p> <p>Our results provide evidence that railway suicides are preceded by identifiable behavioural patterns. This emphasizes the importance of educational efforts, taking into account the knowledge and skills of experienced police officers.</p

Predictors and outcomes in primary depression care (POKAL) – a research training group develops an innovative approach to collaborative care

BACKGROUND: The interdisciplinary research training group (POKAL) aims to improve care for patients with depression and multimorbidity in primary care. POKAL includes nine projects within the framework of the Chronic Care Model (CCM). In addition, POKAL will train young (mental) health professionals in research competences within primary care settings. POKAL will address specific challenges in diagnosis (reliability of diagnosis, ignoring suicidal risks), in treatment (insufficient patient involvement, highly fragmented care and inappropriate long-time anti-depressive medication) and in implementation of innovations (insufficient guideline adherence, use of irrelevant patient outcomes, ignoring relevant context factors) in primary depression care. METHODS: In 2021 POKAL started with a first group of 16 trainees in general practice (GPs), pharmacy, psychology, public health, informatics, etc. The program is scheduled for at least 6 years, so a second group of trainees starting in 2024 will also have three years of research-time. Experienced principal investigators (PIs) supervise all trainees in their specific projects. All projects refer to the CCM and focus on the diagnostic, therapeutic, and implementation challenges. RESULTS: The first cohort of the POKAL research training group will develop and test new depression-specific diagnostics (hermeneutical strategies, predicting models, screening for suicidal ideation), treatment (primary-care based psycho-education, modulating factors in depression monitoring, strategies of de-prescribing) and implementation in primary care (guideline implementation, use of patient-assessed data, identification of relevant context factors). Based on those results the second cohort of trainees and their PIs will run two major trials to proof innovations in primary care-based a) diagnostics and b) treatment for depression. CONCLUSION: The research and training programme POKAL aims to provide appropriate approaches for depression diagnosis and treatment in primary care