Implementation of Cognitive Behavioral Therapy in e–Mental Health Apps: Literature Review

Background: To address the matter of limited resources for treating individuals with mental disorders, e–mental health has gained interest in recent years. More specifically, mobile health (mHealth) apps have been suggested as electronic mental health interventions accompanied by cognitive behavioral therapy (CBT). Objective: This study aims to identify the therapeutic aspects of CBT that have been implemented in existing mHealth apps and the technologies used. From these, we aim to derive research gaps that should be addressed in the future. Methods: Three databases were screened for studies on mHealth apps in the context of mental disorders that implement techniques of CBT: PubMed, IEEE Xplore, and ACM Digital Library. The studies were independently selected by 2 reviewers, who then extracted data from the included studies. Data on CBT techniques and their technical implementation in mHealth apps were synthesized narratively. Results: Of the 530 retrieved citations, 34 (6.4%) studies were included in this review. mHealth apps for CBT exploit two groups of technologies: technologies that implement CBT techniques for cognitive restructuring, behavioral activation, and problem solving (exposure is not yet realized in mHealth apps) and technologies that aim to increase user experience, adherence, and engagement. The synergy of these technologies enables patients to self-manage and self-monitor their mental state and access relevant information on their mental illness, which helps them cope with mental health problems and allows self-treatment. Conclusions: There are CBT techniques that can be implemented in mHealth apps. Additional research is needed on the efficacy of the mHealth interventions and their side effects, including inequalities because of the digital divide, addictive internet behavior, lack of trust in mHealth, anonymity issues, risks and biases for user groups and social contexts, and ethical implications. Further research is also required to integrate and test psychological theories to improve the impact of mHealth and adherence to the e–mental health interventions

How to Motivate Children with Severe Disabilities to Adhere to Their Therapy?

Rehabilitation therapies after a serious accident or disease are usually repetitive and lengthy, requiring high motivation and adherence of the patients to achieve therapy goals. Moreover, the exercises are often painful leading to a decrease in motivation. Keeping motivation and adherence on a high level is even more challenging when the patient is a child or youth. In this paper, we address the question how to motivate this patient group to continuously attend therapy sessions and repeat the painful exercises. To address this issue, we developed the mobile application PAPP with integrated motivation concept that stimulates intrinsic and extrinsic motivation by corresponding features within the app. The intrinsic motivation is considered by means of gamification. An ice bear called "Teddy" and his journey to Spitzbergen is introduced and accompanies the patient journey. The extrinsic motivation is implemented by introducing the virtual currency "Papp-Taler" with integrated rewarding system. The usability test results show promising results. The app still requires extensions such as an external data storage to enable therapists and parents to monitor the progress. In future, it will be possible to use the app in a study to investigate whether it can motivate young patients to adhere to their therapy and whether that has a positive influence on the therapeutic outcome

Error classification as a basis for automating the conformity of production process in the automotive industry

In the automotive industry, the complexity of ensuring production conformity has increased significantly. Reasons for this are a growing number of vehicle variants in combination with increasing regulatory requirements in import markets. Violations of the "Conformity of Production" (CoP) can result in drastic penalties. This is contrasted by a partially random and manual inspection process that is currently not sufficiently automated and digitalized. According to the BMW Group CoP expert workshop there is not enough error analysis and classification in the current situation to comprehensively perform automated inspections. To gain more insight into this manual inspection process, a comprehensive error analysis and classification must first take place to derive measures. Based on the requirements for the CoP process and the findings from the state of the art, the objective of this contribution is to analyze the status quo regarding error frequencies and to derive possible measures from the findings

Visible light is a better co-inducer of apoptosis for curcumin-treated human melanoma cells than UVA

Curcumin attracts worldwide scientific interest due to its anti-proliferative and apoptosis inducing effects on different tumor cells at concentrations ranging from 10 to 150 µM (3.7–55 µg/ml). Unfortunately, because of a low oral bioavailability, only low and pharmacologically ineffective serum levels are achievable. In this study, an alternative treatment concept consisting of low concentration curcumin (0.2–5 µg/ml) and irradiation with UVA or visible light (VL) has been tested. The experimental results show clearly that this treatment decreases the proliferation and the viability of human melanoma cells while the cell membrane integrity remains intact. We identified the onset of apoptosis characterized by typical markers such as active caspases 8, 9 and 3 as well as DNA fragmentation accompanied by the loss of cell adhesion. The mitochondrial apoptosis signaling pathway is predominant due to an early activation of caspase-9. The present data indicate a higher efficacy of a combination of curcumin and VL than curcumin and UVA. Reduced effects as a result of light absorption by heavily pigmented skin are unlikely if VL is used. These results indicate that a combination of curcumin and light irradiation may be a useful additional therapy in the treatment of malignant disease

Creating Individualized Education Material for Diabetes Patients Using the eDiabetes Platform

Diabetes mellitus (DM) is a chronic disease that affects many people in Switzerland and around the world. Once diagnosed, a patient has to continuously monitor blood glucose, manage medications or inject insulin. Technical skills and competencies as well as knowledge on disease management have to be acquired right after being diagnosed. Diabetes consultants support patients in this process and provide educational material. While the process of generating patient-tailored material is currently complex and time consuming, in future, the eDiabetes platform can help. The platform developed in cooperation with the consulting section of the Swiss Diabetes Society offers the opportunity to create individual patient information and instructions to teach technical skills and knowledge on diabetes. Further, an integrated forum allows exchanging information and discussing issues regarding diabetes counselling on a secure platform. Usability tests showed that eDiabetes is easy to use and provides benefits for diabetes consultants and patients

Digital Health Intervention to Support Refugees in Switzerland

Experiences of war and persecution often lead to mental health problems, resulting in post-traumatic stress disorders. In this work, we design a digital platform that aims at helping refugees coming to Switzerland by providing exercises for their mental health and information about daily life in Switzerland. In collaboration with the Swiss Red Cross (SRC), we collected requirements and developed a concept for information provision through in this platform. The architecture of a progressive web application (PWA) was identified as to best fulfill the given requirements. Based on the collected requirements mockups were created. In user interviews, we received feedback regarding the future system. We learned that the platform should include an avatar, which guides the user through the entire platform and asks questions. All texts should be accessible by a read-aloud function and exercises should be provided as videos. In summary, we learned that it is essential to involve the future user group in the development process since it is characterized by cultural diversity that has to be considered in the development and design. Enriched by this input, the next step is to realize the application in terms of a prototype

Renal AA-amyloidosis in intravenous drug users - a role for HIV-infection?

Background: Chronic renal disease is a serious complication of long-term intravenous drug use (IVDU). Recent reports have postulated a changing pattern of underlying nephropathy over the last decades. Methods: Retrospective investigation including all patients with prior or present IVDU that underwent renal biopsy because of chronic kidney disease between 01.04.2002 and 31.03.2012 in the city of Frankfurt/Main, Germany. Results: Twenty four patients with IVDU underwent renal biopsy because of progressive chronic kidney disease or proteinuria. Renal AA-amyloidosis was the predominant cause of renal failure in 50% of patients. Membranoproliferative glomerulonephritis (GN) was the second most common cause found in 21%. Patients with AA-amyloidosis were more likely to be HIV infected (67 vs.17%; p=0.036) and tended to have a higher rate of repeated systemic infections (92 vs. 50%; p=0.069). Patients with AA-amyloidosis presented with progressive renal disease and nephrotic-range proteinuria but most patients had no peripheral edema or systemic hypertension. Development of proteinuria preceded the decline of GFR for approximately 1--2 years. Conclusions: AA-amyloidosis was the predominant cause of progressive renal disease in the last 10 years in patients with IVDU. The highest rate of AA-amyloidosis observed was seen in HIV infected patients with IVDU. We speculate that chronic HIV-infection as well as the associated immunosuppression might promote development of AA-amyloidosis by increasing frequency and duration of infections acquired by IVDU

Extended abstract: gender differences in leader's compliant behaviour: selection into leadership and dishonest behaviour of leaders: a gender experiment

Das erweiterte Abstract beinhaltet die Abschnitte 'Leaders and their incentives to behave non-compliantly', 'the relevance of gender for leader's compliance', die dazu durchgeführte Studie sowie deren Auswertung.The extended abstract consists of two clauses 'leaders and their incentives to behave non-compliantly', 'the relevance of gender for leader's compliance', as well as the related experimental study and it's conclusion