14 research outputs found

    Alginate/silica hybrid materials for immobilization of green microalgae \u3ci\u3eChlorella vulgaris\u3c/i\u3e for cellbased sensor arrays

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    Thin layers and patterned dot arrays of sodium alginate containing living microalgal cells were deposited onto glass carriers which were subsequently gelled using amino-functionalized silica sol to obtain reinforced alginate hydrogels. The resulting alginate/silica hybrid materials showed improved stability in salt-containing solutions compared to alginate gels gelled by traditional methods using Ca2+-ions. Cell arrays were patterned by printing nanolitre-scale drops of sodium alginate/cell suspension using a noncontact micro-dosage system which allows the printing of solutions of high viscosity. Cultures of the green microalga Chlorella vulgaris were immobilized within the newly developed alginate/silica hydrogels in order to demonstrate the potential of the hybrid matrix for the design of cell-based detection systems. The herbicide atrazine as well as copper ions have been used as model toxicants. Short-term toxicity tests (exposure time: 1 h) have been carried out using atrazine and changes in chlorophyll a (Chl a) fluorescence were measured by imaging pulse amplitude modulated-fluorometry (Imaging-PAM). C. vulgaris cells immobilized within alginate/silica hydrogels demonstrated a highly reproducible response pattern and compared well to freely suspended cells. Activity and response sensitivity of immobilized cells to atrazine was largely maintained for up to 8 weeks, especially when stored under cool conditions in the dark. Furthermore, immobilized cells could be repeatingly used for short-term toxicity tests as atrazine produces a reversible inhibition of photosynthesis

    Alginate/silica hybrid materials for immobilization of green microalgae \u3ci\u3eChlorella vulgaris\u3c/i\u3e for cellbased sensor arrays

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    Thin layers and patterned dot arrays of sodium alginate containing living microalgal cells were deposited onto glass carriers which were subsequently gelled using amino-functionalized silica sol to obtain reinforced alginate hydrogels. The resulting alginate/silica hybrid materials showed improved stability in salt-containing solutions compared to alginate gels gelled by traditional methods using Ca2+-ions. Cell arrays were patterned by printing nanolitre-scale drops of sodium alginate/cell suspension using a noncontact micro-dosage system which allows the printing of solutions of high viscosity. Cultures of the green microalga Chlorella vulgaris were immobilized within the newly developed alginate/silica hydrogels in order to demonstrate the potential of the hybrid matrix for the design of cell-based detection systems. The herbicide atrazine as well as copper ions have been used as model toxicants. Short-term toxicity tests (exposure time: 1 h) have been carried out using atrazine and changes in chlorophyll a (Chl a) fluorescence were measured by imaging pulse amplitude modulated-fluorometry (Imaging-PAM). C. vulgaris cells immobilized within alginate/silica hydrogels demonstrated a highly reproducible response pattern and compared well to freely suspended cells. Activity and response sensitivity of immobilized cells to atrazine was largely maintained for up to 8 weeks, especially when stored under cool conditions in the dark. Furthermore, immobilized cells could be repeatingly used for short-term toxicity tests as atrazine produces a reversible inhibition of photosynthesis

    Health-related quality of life among patients with treated alcohol use disorders, schizophreniform disorders or affective disorders and the influence of flexible and integrative psychiatric care models in Germany (PsychCare)

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    IntroductionFlexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity.MethodsWe undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation.ResultsDuring measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, p = 0.003) and comparable HUWs at measurement II (0.581 vs. 0.586, p = 0.584). Symptom severity was comparable between both groups (I: 21.4 vs. 21.1, p = 0.936; II: 18.8 vs. 19.8, p = 0.122). We found lowest HRQoL and highest symptom severity in participants with affective disorders. HRQoL increased and symptom severity decreased over time in both groups. The QWB-SA dimension acute and chronic symptoms was associated with highest detriments in HRQoL. We identified risk/protective factors that were associated with lower quality of life and higher symptom severity in both groups. We confirmed that HRQoL was negatively associated with symptom severity.DiscussionHealth-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups

    Social contacts, friends and satisfaction with friendships in patients with psychotic, mood and neurotic disorders 1\ua0year after hospitalisation: data from five European countries

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    Background: People with severe mental illness often struggle with social relationships, but differences among diagnostic groups are unclear. We assessed and compared objective and subjective social relationship indicators among patients with psychotic, mood and neurotic disorders one year after hospitalisation in five European countries (Belgium, Germany, Italy, Poland and United Kingdom). Methods: The number of social contacts, including family members and friends during the previous week (Social Network Schedule), and satisfaction with the number and quality of friendships (Manchester Short Assessment of Quality of Life Quality) were assessed by face-to-face interview. Linear regression models were used to analyse associations with diagnostic groups. Results: Participants (n = 2155) reported on average 2.79 \ub1 2.37 social contacts overall in the previous week, among whom, a mean of 1.65 \ub1 1.83 (59.2 \ub1 38.7%) were friends. Satisfaction with friendships was moderate (mean 4.62, SD 1.77). In the univariable model, patients with psychotic disorders reported having less social contact with friends than those with either mood (p < 0.05) or neurotic disorders (p < 0.001), but this difference disappeared when adjusting for socioeconomic and clinical variables (\u3b2 = - 0.106, 95% CI - 0.273 to 0.061, p = 0.215). Satisfaction with friendships was similar across diagnostic groups in both univariable (\u3b2 = - 0.066, 95% CI - 0.222 to 0.090, p = 0.408) and multivariable models (\u3b2 = 0.067, 95% CI - 0.096 to 0.229, p = 0.421). The two indicators showed a weak correlation in the total sample (total social contacts, rs = 0.266; p < 0.001; friends, rs = 0.326, p < 0.001). Conclusion: While objective and subjective social relationship indicators appear to be weakly correlated concepts, there is no variation in either indicator across diagnostic groups when confounders are taken into account among patients with severe mental illness. Interventions specifically targeting social relationships are needed, but they do not necessitate diagnosis-specific adaptations

    Settingübergreifende Behandlung in der Psychiatrie: Umsetzung spezifischer Versorgungsmerkmale an Kliniken der Modell- und Regelversorgung (PsychCare-Studie)

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    Hintergrund: Seit 2003 wird an einzelnen psychiatrischen Kliniken ein neues Vergütungs- und Versorgungsmodell erprobt, welches auf Grundlage eines globalen Behandlungsbudgets eine settingübergreifende, integrative sowie Zuhausebehandlung bietet. Derzeit existieren bundesweit 22 dieser psychiatrischen Modellvorhaben nach § 64b SGB V (MV). Die bisherige Forschung konnte 11 spezifische Struktur- und Prozessmerkmale zur Einstufung von MV identifizieren, die allerdings noch nicht in einer kontrollierten Studie hinsichtlich ihrer methodischen Anwendbarkeit überprüft wurden. Untersucht wird die statistische Unterscheidungsfähigkeit der Merkmale an Kliniken der Regel- und der Modellversorgung. Methode: Als Teil der PsychCare-Studie wurde an 9 Modell- und 7 Kontrollkliniken die Einstufung der Merkmale vorgenommen und vergleichend sowie in Subgruppen analysiert. Die Subgruppen unterteilen jene Kliniken, die mit allen oder nur einem Teil der Krankenkassen ein MV vereinbart haben. Ergebnisse: Sieben der 11 Merkmale (Flexibilität im Settingwechsel, settingübergreifende therapeutische Gruppen, Zuhausebehandlung, systematischer Einbezug von Bezugspersonen, Erreichbarkeit von Leistungen, sektorübergreifende Kooperation und Erweiterung professioneller Expertise) wiesen eine hohe statistische Unterscheidungsfähigkeit auf. In den Subgruppen waren diese Unterschiede tendenziell stärker ausgeprägt. Schlussfolgerung: Die modellspezifischen Merkmale sind geeignet, um Qualitätsunterschiede der Implementierung settingübergreifender, flexibler und aufsuchender Versorgung zu evaluieren

    Experiencing (Shared) Decision Making: Results from a Qualitative Study of People with Mental Illness and Their Family Members

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    (1) Background: There is a fundamental shift in healthcare toward shared decision making (SDM). This study explores SDM from the perspective of individuals affected by mental illness and their family members and investigates factors which promote and hinder the process. (2) Methods: We conducted N = 15 telephone interviews (n = 4 adults affected by mental illness, n = 5 family members, n = 6 both applicable, the majority reporting experiences with affective and anxiety disorders). Data were recorded, transcribed, and analyzed according to procedures established by Mayring. (3) Results: Individuals affected by mental illness and their family members have a strong desire to be involved in treatment decisions and to participate in finding a diagnosis. Often these stakeholders are denied the opportunity to participate; sometimes enabling behaviors impede participation. The stigmatization of mental illnesses is a major barrier. There are also structural barriers to SDM within the healthcare system. Peer support, self-help associations, and psychosocial counseling services are important to empowering individuals and promoting SDM. (4) Conclusions: SDM has the potential to improve the quality of mental healthcare. Barriers can be mitigated and new approaches for interventions in the psychiatric sector have been identified. This study has also shown the importance of understanding SDM as a process that should begin at the diagnostic phase

    Demands on Health Information and Clinical Practice Guidelines for Patients from the Perspective of Adults with Mental Illness and Family Members: A Qualitative Study with In-Depth Interviews

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    (1) Background: “Patient health information” promote health literacy. “Patient guidelines” as a sub group reflect the current evidence about illnesses and treatment options adapted to the needs of laypersons. Little is known about factors promoting and hindering their use by people affected by mental illness and their relatives. (2) Methods: Telephone interviews (N = 15; n = 4 adults affected by mental illness, n = 5 relatives, n = 6 both applicable) were conducted according to the Sørensen model of health literacy. Data were recorded, transcribed and content-analyzed following Mayring. (3) Results: Health information is used regularly by individuals affected by mental illness and their relatives, but “patient guidelines” are largely unknown. Yet, there is a great willingness to use them. Main barriers are a lack of statistical knowledge, the complexity of health-related topics and cognitive impairment sometimes accompanying mental illnesses. Target group-oriented adaptation as well as transparent and even-handed presentation of (dis-)advantages of treatment options can increase trust. (4) Conclusions: Health information and guidelines can help affected persons and relatives to make treatment decisions by conveying unbiased, up-to-date knowledge. Target group-specific adaptations should be made for psychiatric illnesses and features specific to mental illnesses compared to physical illnesses should be included. Clinical practice guidelines must be distributed more widely to increase their impact

    Table_1_Health-related quality of life among patients with treated alcohol use disorders, schizophreniform disorders or affective disorders and the influence of flexible and integrative psychiatric care models in Germany (PsychCare).DOCX

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    IntroductionFlexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity.MethodsWe undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation.ResultsDuring measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, p = 0.003) and comparable HUWs at measurement II (0.581 vs. 0.586, p = 0.584). Symptom severity was comparable between both groups (I: 21.4 vs. 21.1, p = 0.936; II: 18.8 vs. 19.8, p = 0.122). We found lowest HRQoL and highest symptom severity in participants with affective disorders. HRQoL increased and symptom severity decreased over time in both groups. The QWB-SA dimension acute and chronic symptoms was associated with highest detriments in HRQoL. We identified risk/protective factors that were associated with lower quality of life and higher symptom severity in both groups. We confirmed that HRQoL was negatively associated with symptom severity.DiscussionHealth-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups.</p

    Melatonin suppression by melanopsin-weighted light in patients with bipolar I disorder compared to healthy controls

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    Background: Multiple lines of evidence suggest that the onset and course of bipolar disorder is influenced by environmental light conditions. Increased suppression of melatonin by light (supersensitivity) in patients with bipolar disorder has been postulated as an endophenotype by several studies. However, due to methodological shortcomings, the results of these studies remain inconclusive. This study investigated melatonin suppression in euthymic patients with bipolar I disorder using evening blue light specifically targeting the melanopsin system. Methods: Melatonin suppression was assessed in euthymic patients with bipolar I disorder and healthy controls by exposure to monochromatic blue light (λmax = 475 nm; photon density = 1.6 × 10¹³ photons/cm²/s) for 30 minutes at 2300 h, administered via a ganzfeld dome for highly uniform light exposure. Serum melatonin concentrations were determined from serial blood sampling via radioimmunoassay. All participants received mydriatic eye drops and were genotyped for the PER3 VNTR polymorphism to avoid or adjust for potential confounding. As secondary outcomes, serum melatonin concentrations during dark conditions and after monochromatic red light exposure (λmax = 624 nm; photon density = 1.6 × 10¹³ photons/cm²/s) were also investigated. Changes in subjective alertness were investigated for all 3 lighting conditions. Results: A total of 90 participants (57 controls, 33 bipolar I disorder) completed the study. Melatonin suppression by monochromatic blue light did not differ between groups (F1,80 = 0.56; p = 0.46). Moreover, there were no differences in melatonin suppression by monochromatic red light (F1,82 = 1.80; p = 0.18) or differences in melatonin concentrations during dark conditions (F1,74 = 1.16; p = 0.29). Healthy controls displayed a stronger increase in subjective alertness during exposure to blue light than patients with bipolar I disorder (t85 = 2.28; p = 0.027). Limitations: Large interindividual differences in melatonin kinetics may have masked a true difference. Conclusion: Despite using a large cohort and highly controlled laboratory conditions, we found no differences in melatonin suppression between euthymic patients with bipolar I disorder and healthy controls. These findings do not support the notion that supersensitivity is a valid endophenotype in bipolar I disorder.</p
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