A Web-Based Self-help Intervention for Coping With the Loss of a Partner: Protocol for Randomized Controlled Trials in 3 Countries.

BACKGROUND The death of a partner is a critical life event in later life, which requires grief work as well as the development of a new perspective for the future. Cognitive behavioral web-based self-help interventions for coping with prolonged grief have established their efficacy in decreasing symptoms of grief, depression, and loneliness. However, no study has tested the efficacy for reducing grief after losses occurring less than 6 months ago and the role of self-tailoring of the content. OBJECTIVE This study aims to evaluate the clinical efficacy and acceptance of a web-based self-help intervention to support the grief process of older adults who have lost their partner. It will compare the outcomes, adherence, and working alliance in a standardized format with those in a self-tailored delivery format and investigate the effects of age, time since loss, and severity of grief at baseline as predictors. Focus groups to understand user experience and a cost-effectiveness analysis will complement the study. METHODS The study includes 3 different randomized control trials. The trial in Switzerland comprises a waitlist control group and 2 active arms consisting of 2 delivery formats, standardized and self-tailored. In the Netherlands and in Portugal, the trials follow a 2-arm design that will be, respectively, complemented with focus groups on technology acceptance and cost-effectiveness analysis. The main target group will consist of adults aged >60 years from the general population in Switzerland (n≥85), the Netherlands (n≥40), and Portugal (n≥80) who lost their partner and seek help for coping with grief symptoms, psychological distress, and adaptation problems in daily life. The trials will test the intervention's clinical efficacy for reducing grief (primary outcome) and depression symptoms and loneliness (secondary outcomes) after the intervention. Measurements will take place at baseline (week 0), after the intervention (week 10), and at follow-up (week 20). RESULTS The trials started in March 2022 and are expected to end in December 2022 or when the needed sample size is achieved. The first results are expected by January 2023. CONCLUSIONS The trials will provide insights into the efficacy and acceptance of a web-based self-help intervention among older adults who have recently lost a partner. Results will extend the knowledge on the role of self-tailoring, working alliance, and satisfaction in the effects of the intervention. Finally, the study will suggest adaptations to improve the acceptance of web-based self-help interventions for older mourners and explore the cost-effectiveness of this intervention. Limitations include a self-selective sample and the lack of cross-cultural comparisons. TRIAL REGISTRATION Switzerland: ClinicalTrials.gov NCT05280041; https://clinicaltrials.gov/ct2/show/NCT05280041; Portugal: ClinicalTrials.gov NCT05156346; https://clinicaltrials.gov/ct2/show/NCT05156346. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37827

Untersuchungen über die Abhängigkeit des Gesamtserumcholesterinspiegels der Ratte von Alter, Geschlecht und von der Jahreszeit

Peer Reviewe

Relaxation Time Mapping in Skeletal Muscle During Reactive Hyperemia

To obtain further information on the origins of measured signal changes during short term ischemia / reactive hyperemia, the pu rpose of the present study was the dynamic measurement of the relaxation times T1, T2 and T2* during a cuff-compression paradigm on the human calf. No paradigm related changes in T1 were observed. T2 and T2* time courses showed the expected behavior. The calculated initial intensity I0 decreased during ischemia and did not show a large overshoot during reactive hyperemia. This excludes an increase of blood volume as a reason for longer transversal relaxation times observed during reactive hyperemia

Assessment of muscle oxygenation with balanced SSFP: a quantitative signal analysis

PURPOSE: To investigate the feasibility of balanced steady-state free precession (b-SSFP) for blood oxygenation level-dependent (BOLD) MRI during a short-term ischemia/reactive hyperemia (RH) experiment on human calf muscles. MATERIALS AND METHODS: To investigate contributions to the b-SSFP signal during an RH experiment, the relaxation times T(1), T(2), and T(2) (*) were quantified in an interleaved fashion. Data from soleus, gastrocnemius, and tibialis muscle groups of five healthy subjects were evaluated. RESULTS: During ischemia a decreased b-SSFP signal amplitude as well as a decrease in T(2), T(2) (*), and the initial intensity I(0) was observed. RH provoked an overshoot of T(2), T(2) (*), and the b-SSFP signal. No paradigm-related changes in T(1) were observed. Comparing the evolution of transverse relaxation times, initial intensity, and b-SSFP signal amplitude, we concluded that the measured b-SSFP signal in muscle tissue is not only determined by T(2) variations but also significantly influenced by I(0) changes. These I(0) changes are attributed to spin density variations since inflow effects were suppressed by saturation bands. CONCLUSION: b-SSFP signal changes during a RH paradigm cannot unambiguously be assigned to oxygenation changes. Therefore, care has to be taken with their interpretation