Psychosoziale Beeinträchtigungen von Patienten mit fokaler Hyperhidrosis mit besonderer Beachtung der Lebensqualität

Die primäre fokale Hyperhidrosis stellt eine Erkrankung, die durch ein exzessives Maß an Schweiß charakterisiert ist und oftmals starke Auswirkungen auf die gesundheitsbezogene Lebensqualität der betroffenen Personen hat (Achenbach, 2004; Rzany & Hund, 2003). Bisherige Untersuchungen zeigen Zusammenhänge von Hyperhidrosis, Sozialer Angst und Lebensqualität (Kumagai et al., 2005; Milanez de Campos et al., 2003; Panhofer et al., 2006; Telaranta, 1998). Ziel der vorliegenden Studie ist die systematische Analyse von Auswirkungen der primären fokalen Hyperhidrosis auf die psychosoziale Situation, unter besonderer Beachtung der gesundheitsbezogenen Dimensionen der Lebensqualität von Betroffenen, wie auch eine Evaluation eines T4-Sympathikusblocks. Insgesamt wurden 68 Personen getestet, wobei nach erfolgter ESB 25 an der zweiten Testung und 11 an der dritten Testung 8-12 Monate später teilnahmen. Neben einem diagnostischen Interview und pathologiespezifischen Fragen wurden der SF-36 zur Erfassung der gesundheitsbezogenen Lebensqualität, der LSAS und SIAS zur Erfassung der Sozialen Angst, sowie der UFB zur Erfassung Sozialer Kompetenzen für die Untersuchung verwendet. Die Ergebnisse dieser Untersuchung bestätigen vor allem einen direkten Zusammenhang zwischen Sozialer Angst und psychischem Wohlbefinden (β=-0.57; p<0.001) als Teilbereich der gesundheitsbezogenen Lebensqualität. Ebenfalls konnten Verbesserungen in der soziale Funktionsfähigkeit (T2[24]: T=-3.715; p<0.001; T3[2,9]: F=5.190; ε=0.779; p<0.013) und der Angst vor Interaktionen (T2[24]: T=3.145; p<0.004; T3[2,9]: F=5.190; ε=0.878; p<0.023) nachgewiesen werden. Bezüglich der Sozialer Kompetenzen und des Vermeidungsverhaltens der betroffenen Personen konnten keine signifikanten Veränderungen über die Testzeitpunkte festgestellt werden. Die Ergebnisse implizieren nicht lediglich einen guten und anhaltenden Erfolg der ESB, sondern zeigen auch die Wichtigkeit eines biopsychosozialen Ansatzes auf.Primary focal hyperhidrosis is characterized by excessive sweating. Patients suffering from hyperhidrosis are highly limited in their health-related quality of life (Achenbach, 2004; Kumagai et al., 2005; Panhofer et al., 2006; Rzany & Hund, 2003) and show often comorbid mental disorders like social anxiety (Connor et al., 2006; Davidson et al., 2002; Telaranta, 1998). Aim of the current study is to investigate the impact of focal hyperhidrosis on social anxiety and health related quality of life. Another important aspect is the evaluation of a reversible T4-Sympathikusblock (ESB) focussing on several aspects of social anxiety and a broad range of dimensions in health related quality of life. 68 participants were investigated. The evaluation of the ESB was calculated using the data of 25 participants for the second assessment. 11 of this patients participated at the follow-up 8-12 month after ESB. Following a diagnostic interview to diagnose mental disorders and a hyperhidrosis questionnaire the SF-36 was used to measure health related quality of life and LSAS and SIAS were used for the assessment of social anxiety. Additionally the UFB was used to investigate some social competencies. Results show effects of social anxiety on psychological well-being (β=-0.57; p<0.001) as part of the health related quality of life. The evaluation shows an increase in social functioning (T2[24]: T=-3.715; p<0.001; T3[2,9]: F=5.190; ε=0.779; p<0.013) and a decrease in social anxiety (T2[24]: T=3.145; p<0.004; T3[2,9]: F=5.190; ε=0.878; p<0.023) after ESB, and invariable effects between the post-test and the follow-up. There was no significant increase in social competencies and avoidance behaviour as additional aspects of social anxiety. These results indicate that psychosocial aspects in hyperhidrosis play an important role. Therefore and given to the small effects concerning social competencies and avoidance behaviour a biopsychosocial approach is needed for an adequate intervention

Applicability of Immersive Analytics in Mixed Reality: Usability Study

Nowadays, visual analytics is mainly performed by programming approaches and viewing the results on a desktop monitor. However, due to the capabilities of smart glasses, new user interactions and representation possibilities become possible. This refers especially to 3D visualizations in the medical field, as well as, the industry domain, as valuable depth information can be related to the complex real-world structures and related data, which is also denoted as immersive analytics. However, the applicability of immersive analytics and its drawbacks, especially in the context of mixed reality, are quite unexplored. In order to validate the feasibility of immersive analytics for the aforementioned purposes, we designed and conducted a usability study with 60 participants. More specifically, we evaluated the effects of spatial sounds, performance changes from one analytics task to another, expert status, and compared an immersive analytics approach (i.e., a mixed-reality application) with a desktop-based solution. Participants had to solve several data analytics tasks (outlier’s detection and cluster recognition) with the developed mixed-reality application. Thereby, the performance measures regarding time, errors, and movement patterns were evaluated. The separation into groups (low performer vs. high performer) was performed using a mental rotation pretest. When solving analytic tasks in mixed reality, participants changed their movement patterns in the mixed reality setting significantly, while the use of spatial sounds reduced the handling time significantly, but did not affect the movement patterns. Furthermore, the usage of mixed reality for cluster recognition is significantly faster than the desktop-based solution (i.e., a 2D approach). Moreover, the results obtained with self-developed questionnaires indicate 1) that wearing smart glasses are perceived as a potential stressor and 2) that the utilization of sounds is perceived very differently by the participants. Altogether, industry and researchers should consider immersive analytics as a suitable alternative compared to the traditional approaches

Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents’ opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child’s age, delays in accessing services, and active stakeholders’ participation when looking to improve services

Psychological and physiological human responses to simulated and real environments: A comparison between Photographs, 360° Panoramas, and Virtual Reality

[EN] Psychological research into human factors frequently uses simulations to study the relationship between human behaviour and the environment. Their validity depends on their similarity with the physical environments. This paper aims to validate three environmental-simulation display formats: photographs, 360° panoramas, and virtual reality. To do this we compared the psychological and physiological responses evoked by simulated environments set-ups to those from a physical environment setup; we also assessed the users' sense of presence. Analysis show that 360° panoramas offer the closest to reality results according to the participants' psychological responses, and virtual reality according to the physiological responses. Correlations between the feeling of presence and physiological and other psychological responses were also observed. These results may be of interest to researchers using environmental-simulation technologies currently available in order to replicate the experience of physical environments.This work was supported by the Ministerio de Economia y Competitividad. Spain (Project TIN2013-45736-R).Higuera-Trujillo, JL.; López-Tarruella Maldonado, J.; Llinares Millán, MDC. (2017). Psychological and physiological human responses to simulated and real environments: A comparison between Photographs, 360° Panoramas, and Virtual Reality. Applied Ergonomics. 65:398-409. https://doi.org/10.1016/j.apergo.2017.05.006S3984096

Use of a non-human robot audience to induce stress reactivity in human participants

This study examined whether a non-human robot audience can elicit a stress response in human participants. A 90-minute experimental laboratory session based on the Trier Social Stress Test (TSST) using a pre-recorded robot audience, was presented as a live on-screen simulation. Nineteen participants (female=16) aged 21–57 years (M=29.74) underwent a ten-minute mock interview and mathematics task in front of the robot audience. Salivary cortisol was assessed at 10-minutes before and immediately prior to the start of the stress test, and +10-, +30- and +40-minutes after the start of the test. Heart rate was assessed 20 minutes before, at five minutes into and 40-minutes after the test. Perceived stress and trait coping responses were provided at entry and participants were interviewed post task about their subjective experience. Significant increases in salivary cortisol and heart rate were observed over time with no significant interactions by participant subjective report. Coping responses including active coping and planning showed significant relationships with cortisol and heart rate reactivity and recovery. Until now, a non-human robot audience has not been used in a social stress testing paradigm. This methodology offers an innovative application with potential for further in-depth evaluation of stress reactivity and adaptation

A Systematic Review of Social Presence: Definition, Antecedents, and Implications

Social presence, or the feeling of being there with a “real” person, is a crucial component of interactions that take place in virtual reality. This paper reviews the concept, antecedents, and implications of social presence, with a focus on the literature regarding the predictors of social presence. The article begins by exploring the concept of social presence, distinguishing it from two other dimensions of presence—telepresence and self-presence. After establishing the definition of social presence, the article offers a systematic review of 233 separate findings identified from 152 studies that investigate the factors (i.e., immersive qualities, contextual differences, and individual psychological traits) that predict social presence. Finally, the paper discusses the implications of heightened social presence and when it does and does not enhance one's experience in a virtual environment

WIE DEPRESSIONEN VORBEUGEN? AKTUELLE BESTREBUNGEN UND KÜNFTIGE HERAUSFORDERUNGEN BEI KINDERN MIT CHRONISCHEN ERKRANKUNGEN

With its high rates of chronicity and concomitant economic costs to society, depression ranges among the most prevalent mental disorders. Several trials have succeeded in demonstrating the beneficial effects of early depression prevention programs for otherwise healthy children and adolescents. However, comparable programs for children and adolescents with a medical condition are still scarce. This paper discusses the situation of chronically ill children and adolescents who are at risk of developing comorbid depressive symptoms using the example of three conditions frequently encountered in pediatric psychosomatic medicine: diabetes, epilepsy and inflammatory bowel disease (IBD). Each patient group is introduced with regards to specific risk factors and correlates of depression. Also, existing customized depression prevention programs and according research trials are presented. Reviewing the body of literature, it becomes apparent that risk factor research and depression prevention are still in their infancy for these three patient groups. While new risk factor models and biomarker approaches emerge as a promising rationale for depression prevention, research is called upon to include randomized control trials as well as longitudinal designs in order to achieve more optimally tailored preventive interventions for children and adolescents with chronic medical conditions.Mit ihren hohen Chronifizierungsraten und gesellschaftlichen Kosten rangiert die Depression unter den häufigsten psychischen Störungen. Einzelne Studien haben die Vorteile früher Präventionsprogramme für andernfalls gesunde Kinder und Jugendliche aufgezeigt. Vergleichbare Programme für Kinder und Jugendliche mit einer somatischen Erkrankung fehlen jedoch noch größtenteils. Dieser Artikel diskutiert die Situation chronisch kranker Kinder und Jugendlicher, welche ein hohes Risiko haben an einer Depression zu erkranken, wobei insbesondere die folgenden drei, in der Pädiatrischen Psychosomatik häufig anzutreffenden Krankheitsbilder gesondert betrachtet werden: Diabetes, Epilepsie und chronisch entzündliche Darmerkrankungen. Jede dieser Patientengruppen wird anhand der jeweils spezifischen Risikofaktoren und Korrelaten der Depression beschrieben. Auch werden maßgeschneiderte Präventionsprogramme und entsprechende Forschungsunterfangen präsentiert. Angesichts der Studienlage wird offenkundig, dass sowohl die Risikofaktorenforschung als auch die Prävention von Depression für diese drei Patientengruppen noch in den Kinderschuhen steckt. Während neue Risikofaktorenmodelle und Biomarker-Ansätze einen vielversprechenden Zugang zur Prävention bieten, steht die Forschung weiterhin vor der Herausforderung, randomisierte Kontrollstudien sowie Längsschnittdesigns zu inkorporieren, um individuell besser angepasste Präventionsprogramme für Kinder und Jugendliche mit chronischen Erkrankungen zu entwickeln

Knowledge about and attitudes towards medical cannabis among Austrian university students

Background: The relevance of medical cannabis (MC) increases; and, educating those who are at the forefront of patient care is imperative. Yet, research on medical students’ expertise and opinions is still scarce. Objective: This study set out to evaluate Austrian medical students’ knowledge about and attitudes towards MC and compare them with other academic disciplines. Additionally, gender was controlled for. Methods: An online survey was conducted with N = 404 students enrolled in (1) medical studies, (2) studies with a medical background and (3) studies without a medical background. Results: In contrast to non-medical students, 64 % of medical students said they learnt about MC at the university. Although students were confident about their knowledge, they struggled to differentiate between CBD and THC. Chronic pain, oncological diseases and palliative care were the most frequently cited indications, psychiatric indications, however, were mentioned less often. Medical students were more reserved in their attitudes towards increasing medical usage and legalizing cannabis than the two other groups. Also, they were more skeptical about whether physicians should be allowed to prescribe MC and whether they should be obliged to offer it. Males showed more confidence regarding cannabis knowledge and were more favorable of legalizing and prescribing cannabis; females perceived cannabis as more physically addictive and as a gate-way drug. Conclusions: Considering that beliefs and attitudes shape behavior, it is expected that future health care professionals will struggle with recommending cannabis for medical treatment. A coordinated approach for medical training is needed to ensure high standard medical care

Transcultural Differences in Risk Factors and in Triggering Reasons of Suicidal and Self-Harming Behaviour in Young People with and without a Migration Background

Minors with and without migration background can have different risk factors and triggering reasons for self-harming and suicidal behaviour. We retrospectively analysed the data of 192 children and adolescents to investigate the transcultural differences in self-harming, as well as suicidal behaviour in Austrian, Turkish, and Bosnian/Croatian/Serbian (BCS)-speaking patients, who were treated in an emergency out-patient clinic in Vienna. Our results showed transcultural differences in both behaviours. In all groups, females had higher rates of suicide attempts and self-harming behaviour than males. While Turkish-speaking patients received treatment more often, after attempted suicide, Austrians and BCS-speaking patients needed treatment more often for acute stress disorder. Suicide attempts and self-harming behaviours were triggered most frequently by intrafamilial problems, but more frequently in migrant patients. Turkish-speaking patients were at a more than 2 times (OR = 2.21, 95%CI: 1.408–3.477) higher risk for suicide attempts, and were triggered almost 3 times (OR = 2.94, 95%CI: 1.632–5.304) more often by interfamilial conflicts. The suicide attempts of BCS-speaking minors were more often caused by relationship and separation crises (OR = 2.56, 95%CI: 1.148–5.705). These transcultural differences in suicidal and self-harming behaviour of minors, demand an increase of transcultural competence to provide optimal treatment of migrant children