61 Medizin und Gesundheit
Filtern
Dokumenttyp
- Wissenschaftlicher Artikel (Fachzeitschriften) (37) (entfernen)
Sprache
- Englisch (37)
Volltext vorhanden
- ja (37)
Gehört zur Bibliographie
- nein (37)
Schlagworte
- Rückenschmerz (11)
- Physikalische Therapie (5)
- Maschinelles Lernen (4)
- low back pain (4)
- stratified care (4)
- Elektrode (3)
- Intervention <Medizin> (3)
- Jugend (3)
- Sport (3)
- Sportler (3)
- back pain (3)
- sports (3)
- Übung (3)
- Alkoholmissbrauch (2)
- Bewegungsapparat (2)
- Convolutional Neural Network (2)
- Flüssigkristalline Polymere (2)
- Gesundheitswesen (2)
- Hirnstimulation (2)
- Kreuzschmerz (2)
- Leistungssportler (2)
- Nigeria (2)
- Parkinson-Krankheit (2)
- Prävention (2)
- Rehabilitation (2)
- Sportverletzung (2)
- Therapie (2)
- alcohol (2)
- deep brain stimulation (2)
- electrode model (2)
- exercise (2)
- health services research (2)
- internet (2)
- machine learning (2)
- perturbation (2)
- physiotherapy (2)
- psychometrics (2)
- rehabilitation (2)
- ultrasound (2)
- young people (2)
- Anomalie <Medizin> (1)
- Anomalieerkennung (1)
- Apoptosis (1)
- Apotheke (1)
- App <Programm> (1)
- Astrozyt (1)
- Bewegung (1)
- Bewegungsstörung (1)
- Bilderkennung (1)
- Bildgebendes Verfahren (1)
- Bindegewebe (1)
- Biofeedback-Therapie (1)
- CNN (1)
- Chronischer Schmerz (1)
- DNN (1)
- Deep learning (1)
- Delphi survey (1)
- Demenz (1)
- Depression (1)
- Deutschland (1)
- Dienstleistung (1)
- Dynamometer (1)
- E-Health (1)
- EHR (1)
- EMG (1)
- Einzelhandel (1)
- Electronic Commerce (1)
- Elektrokortikogramm (1)
- Elektromyographie (1)
- Elektronische Patientenakte (1)
- Elektrophysiologie (1)
- Ellbogengelenk (1)
- Epidemiologie (1)
- Essenzieller Tremor (1)
- Forschung (1)
- Gesundheitspolitik (1)
- Gesundheitsökonomie (1)
- Gyrus temporalis (1)
- Haltung (1)
- Handy (1)
- Hemisphäre <Anatomie> (1)
- Herzmuskelkrankheit (1)
- Hirnareal (1)
- Hüftgelenkprothese (1)
- ICU (1)
- Intensivpflege (1)
- Intensivstation (1)
- Internet (1)
- Kniegelenk (1)
- Kniegelenkprothese (1)
- Kommunikation (1)
- Krankengymnastik (1)
- Künstliche Beatmung (1)
- Künstliche Intelligenz (1)
- LBP (1)
- Laborparameter (1)
- Laser-Rastermikroskopie (1)
- Leistung (1)
- Linke Hemisphäre (1)
- Läsion (1)
- Magnetische Stimulation (1)
- Medizinische Ausbildung (1)
- Medizinische Informatik (1)
- MiSpEx (1)
- Musculus biceps brachii (1)
- Muskel-Skelett-Erkrankung (1)
- Muskelkater (1)
- Myalgie (1)
- Nachsorge (1)
- Nervenkrankheit (1)
- Neuronales Netz (1)
- Petri nets (1)
- Pflegepersonal (1)
- Physiotherapeut (1)
- Primäre Gesundheitsversorgung (1)
- Psychometrie (1)
- Public Health (1)
- Raucherentwöhnung (1)
- Rekursives neuronales Netz (1)
- Ressourcen am Arbeitsplatz (1)
- Risikofaktor (1)
- Rotatorenmanschette (1)
- Rumpf (1)
- STarT back tool (1)
- STarT-Back approach (1)
- Schlaganfall (1)
- Schmerz (1)
- Schultergelenk (1)
- Schädigung (1)
- Sensomotorik (1)
- Sensor (1)
- Soziale Norm (1)
- Sozialmedizin (1)
- Stabilisierung (1)
- Stress (1)
- Stressbewältigung (1)
- Stressor (1)
- Student (1)
- Studium (1)
- Substantia alba (1)
- Telemedizin (1)
- Test (1)
- Training (1)
- Trainingsprogramm (1)
- Transkranielle magnetische Stimulation (1)
- Ultraschall (1)
- Unique Selling Proposition (1)
- Universität (1)
- VLSM (1)
- VentAI (1)
- Vibroarthrographie (1)
- Work-Life-Balance (1)
- Zentralnervensystem (1)
- adolescent athletes (1)
- aftercare (1)
- anomaly detection (1)
- apoptosis (1)
- arithmetic fact retrieval (1)
- artificial intelligence (1)
- astrocytes (1)
- biceps brachii (1)
- charge storage capacity (CSCc) (1)
- chronic low back pain (1)
- chronic non-specific low back pain (1)
- clinical decision making (1)
- complaints (1)
- complex prognostic factors (1)
- connective tissue (1)
- connectivity (1)
- convolutional neural networks (1)
- core (1)
- cortical electrical stimulation (1)
- cortical stimulation (1)
- critical care (1)
- critically-ill patient (1)
- curriculum (1)
- curved trajectory (1)
- deep learning (1)
- dementia (1)
- diagnostics imaging (1)
- disability (1)
- disconnectome (1)
- doctor of physical therapy (1)
- dynamic postural control test (1)
- education (1)
- electrocorticogram (1)
- electrode impedance (1)
- electrode reconstruction (1)
- electroplating (1)
- epidemiology (1)
- evaluation (1)
- exercise therapy (1)
- exergame (1)
- health policy (1)
- health services administration & management (1)
- health technologies (1)
- home-based (1)
- image recognition (1)
- implementation strategies (1)
- in vivo two-photon laser-scanning microscopy (1)
- in-store health services (1)
- injury prevention program (IPP) (1)
- injury prevention programs (IPP) (1)
- instability (1)
- intensive care (1)
- interpretability (1)
- knee joint sound (1)
- lab values (1)
- lesion mapping (1)
- lightGBM (1)
- liquid crystal polymer electrodes (1)
- medical consumables (1)
- medical economics (1)
- medical informatics (1)
- mobile phone (1)
- modeling (1)
- morphology (1)
- motor control exercises (1)
- movement disorders (1)
- muscle damage (1)
- muscle fatiguing exercise (1)
- muscle pain (1)
- musculoskeletal care (1)
- musculoskeletal disorder (1)
- musculoskeletal system (1)
- necroptosis (1)
- neuron-glia interaction (1)
- non-specifc (1)
- nursing staff (1)
- one-legged stance test (1)
- optimization (1)
- output impedance (1)
- overhead athlete (1)
- overuse injuries (1)
- pain intensity (1)
- patient reported outcomes (1)
- patient-reported outcomes (1)
- patients' perceptions (1)
- performance (1)
- pharmaceutical services (1)
- physical therapy (1)
- platinum (1)
- primary health care (1)
- problem drinking (1)
- prognosis (1)
- public health (1)
- pulsed current (1)
- qualitative research (1)
- questionnaire (1)
- reinforcement learning algorithm (1)
- responsiveness (1)
- retail clinics (1)
- retail pharmacies (1)
- risk factors (1)
- rotator cuff (1)
- sensorimotor training (1)
- septic cardiomyopathy (1)
- small data (1)
- smoking cessation (1)
- social medicine (1)
- social norms (1)
- spectral estimation (1)
- sports-related injuries (1)
- stabilization exercise (1)
- star excursion balance test (1)
- static postural control test (1)
- stimulator characterization (1)
- stimulator model (1)
- stratification (1)
- stress (1)
- students (1)
- symptoms (1)
- targeted treatment (1)
- telerehabilitation (1)
- text messaging (1)
- time series classification (1)
- tobacco (1)
- total hip replacement (1)
- total knee replacement (1)
- training intervention (1)
- tremor (1)
- trunk stability (1)
- unstable resistance training (1)
- usability (1)
- ventilation (1)
- vibroarthrography (1)
- warm-up exercise (1)
- water pipe (1)
- wearable motion sensors (1)
- web (1)
- workplace stressors (1)
- Überlastungsschaden (1)
- Übungsprogramm (1)
Institut
Disconnection in a left-hemispheric temporo-parietal network impairs multiplication fact retrieval
(2023)
Arithmetic fact retrieval has been suggested to recruit a left-lateralized network comprising perisylvian language areas, parietal areas such as the angular gyrus (AG), and non-neocortical structures such as the hippocampus. However, the underlying white matter connectivity of these areas has not been evaluated systematically so far. Using simple multiplication problems, we evaluated how disconnections in parietal brain areas affected arithmetic fact retrieval following stroke. We derived disconnectivity measures by jointly considering data from n = 73 patients with acute unilateral lesions in either hemisphere and a white-matter tractography atlas (HCP-842) using the Lesion Quantification Toolbox (LQT). Whole-brain voxel-based analysis indicated a left-hemispheric cluster of white matter fibers connecting the AG and superior temporal areas to be associated with a fact retrieval deficit. Subsequent analyses of direct gray-to-gray matter disconnections revealed that disconnections of additional left-hemispheric areas (e.g., between the superior temporal gyrus and parietal areas) were significantly associated with the observed fact retrieval deficit. Results imply that disconnections of parietal areas (i.e., the AG) with language-related areas (i.e., superior and middle temporal gyri) seem specifically detrimental to arithmetic fact retrieval. This suggests that arithmetic fact retrieval recruits a widespread left-hemispheric network and emphasizes the relevance of white matter connectivity for number processing.
Background: Stratified care approach involving use of the STarT-Back tool to optimise care for patients with low back pain is gaining widespread attention in western countries. However, adoption and implementation of this approach in low-and-middle-income countries will be restricted by context-specific factors that need to be addressed. This study aimed to develop with physiotherapists, tailored intervention strategies for the implementation of stratified care for patients with low back pain.
Methods: A two-round web-based Delphi survey was conducted among purposively sampled physiotherapists with a minimum of three years of clinical experience, with post-graduation certification or specialists. Thirty statements on barriers and enablers for implementation were extracted from the qualitative phase. Statements were rated by a Delphi panel with additional open-ended feedback. After each Delphi round, participants received feedback which informed their subsequent responses. Additional qualitative feedback were analysed using qualitative content analysis. The criteria for consensus and stability were pre-determined using percentage agreement (≥ 75%), median value (≥ 4), Inter-quartile range (≤ 1), and Wilcoxon matched-pairs test respectively.
Results: Participants in the first round were 139 and 125 of them completed the study, yielding a response rate of 90%. Participants were aged 35.2 (SD6.6) years, and 55 (39.6%) were female. Consensus was achieved in 25/30 statements. Wilcoxon’s test showed stability in responses after the 5 statements failed to reach consensus: ‘translate the STarT-Back Tool to pidgin language’ 71% (p = 0.76), ‘begin implementation with government hospitals’ 63% (p = 0.11), ‘share knowledge with traditional bone setters’ 35% (p = 0.67), ‘get second opinion on clinician’s advice’ 63% (p = 0.24) and ‘carry out online consultations’ 65% (p = 0.41). Four statements strengthened by additional qualitative data achieved the highest consensus: ‘patient education’ (96%), ‘quality improvement appraisals’ (96%), ‘undergraduate training on psychosocial care’ (96%) and ‘patient-clinician communication’ (95%).
Conclusion: There was concordance of opinion that patients should be educated to correct misplaced expectations and proper time for communication is vital to implementation. This communication should be learned at undergraduate level, and for already qualified clinicians, quality improvement appraisals are key to sustained and effective care. These recommendations provide a framework for future research on monitored implementation of stratified care in middle-income countries.
Background: In recent years, the volume of medical knowledge and health data has increased rapidly. For example, the increased availability of electronic health records (EHRs) provides accurate, up-to-date, and complete information about patients at the point of care and enables medical staff to have quick access to patient records for more coordinated and efficient care. With this increase in knowledge, the complexity of accurate, evidence-based medicine tends to grow all the time. Health care workers must deal with an increasing amount of data and documentation. Meanwhile, relevant patient data are frequently overshadowed by a layer of less relevant data, causing medical staff to often miss important values or abnormal trends and their importance to the progression of the patient’s case.
Objective: The goal of this work is to analyze the current laboratory results for patients in the intensive care unit (ICU) and classify which of these lab values could be abnormal the next time the test is done. Detecting near-future abnormalities can be useful to support clinicians in their decision-making process in the ICU by drawing their attention to the important values and focus on future lab testing, saving them both time and money. Additionally, it will give doctors more time to spend with patients, rather than skimming through a long list of lab values.
Methods: We used Structured Query Language to extract 25 lab values for mechanically ventilated patients in the ICU from the MIMIC-III and eICU data sets. Additionally, we applied time-windowed sampling and holding, and a support vector machine to fill in the missing values in the sparse time series, as well as the Tukey range to detect and delete anomalies. Then, we used the data to train 4 deep learning models for time series classification, as well as a gradient boosting–based algorithm and compared their performance on both data sets.
Results: The models tested in this work (deep neural networks and gradient boosting), combined with the preprocessing pipeline, achieved an accuracy of at least 80% on the multilabel classification task. Moreover, the model based on the multiple convolutional neural network outperformed the other algorithms on both data sets, with the accuracy exceeding 89%.
Conclusions: In this work, we show that using machine learning and deep neural networks to predict near-future abnormalities in lab values can achieve satisfactory results. Our system was trained, validated, and tested on 2 well-known data sets to ensure that our system bridged the reality gap as much as possible. Finally, the model can be used in combination with our preprocessing pipeline on real-life EHRs to improve patients’ diagnosis and treatment.
The future of German pharmacy business models with retail clinics as USP against online pharmacies
(2022)
Purpose: This study aims to discuss the chances of in-store pharmacies through in-store health services, e. g. vaccinations or Covid-19 tests, in Germany. As a result, retail clinics could lead to a USP against online pharmacies. Additionally, the study will show how possible retail clinics could look like and how the acceptance in the population is.
Research Methodology: To conduct the survey, Google Forms was used together with MS Excel for the analysis. Various studies were reviewed, and care was taken to work as closely as possible to practice and its figures from e. g. associations, companies, or statista.
Results: The launch of retail clinics could give German stationary pharmacies a new boost and differentiate them from online pharmacies on the market. Pharmaceutical services are in great demand among the population, hopefully, the legal framework will soon be in place, and the proper services will have to be offered to be able to fully generate the large sales potential.
Discussion and Conclusion: The study only points to a general overview of how health services can help store pharmacies in the competition with online pharmacies in Germany. Yet there are also other possible USPs for store pharmacies, which are not concluded in that study. In addition, the legal framework under which pharmacies operate must be analyzed in detail by legal experts to obtain a precise overview of what is possible for pharmacies in the area of pharmaceutical services and retail clinics. The study is useful for pharmacists, business economists in general as well as in health care management.
Decoding the cellular network interaction of neurons and glial cells are important in the development of new therapies for diseases of the central nervous system (CNS). Electrophysiological in vivo studies in mice will help to understand the highly complex network. In this paper, the optimization of epidural liquid crystal polymer (LCP) electrodes for different platinum electroplating parameters are presented and compared. Constant current and pulsed current electroplating varied in strength and duration was used to decrease the electrode impedance and to increase the charge storage capacity (CSCc). In best cases, both methods generated similar results with an impedance reduction of about 99%. However, electroplating with pulsed currents was less parameter-dependent than the electroplating with constant current. The use of ultrasound was essential to generate platinum coatings without plating defects. Electrode model parameters extracted from the electrode impedance reflected the increase in surface porosity due to the electroplating processes.
Intervention in the form of core-specific stability exercises is evident to improve trunk stability. The purpose was to assess the effect of an additional 6 weeks sensorimotor or resistance training on maximum isokinetic trunk strength and response to sudden dynamic trunk loading (STL) in highly trained adolescent athletes. The study was conducted as a single-blind, 3-armed randomized controlled trial. Twenty-four adolescent athletes (14f/10 m, 16 ± 1 yrs.;178 ± 10 cm; 67 ± 11 kg; training sessions/week 15±5; training h/week 22±8) were randomized into resistance training (RT; n=7), sensorimotor training (SMT; n = 10), and control group (CG; n = 7). Athletes were instructed to perform standardized, center-based training for 6 weeks, two times per week, with a duration of 1 h each session. SMT consisted of four different core-specific sensorimotor exercises using instable surfaces. RT consisted of four trunk strength exercises using strength training machines, as well as an isokinetic dynamometer. All participants in the CG received an unspecific heart frequency controlled, ergometer-based endurance training (50 min at max. heart frequency of 130HF). For each athlete, each training session was documented in an individual training diary (e.g., level of SMT exercise; 1RM for strength exercise, pain). At baseline (M1) and after 6 weeks of intervention (M2), participants’ maximum strength in trunk rotation (ROM:63°) and flexion/extension (ROM:55°) was tested on an isokinetic dynamometer (concentric/eccentric 30°/s). STL was assessed in eccentric (30°/s) mode with additional dynamometer-induced perturbation as a marker of core stability. Peak torque [Nm] was calculated as the main outcome. The primary outcome measurements (trunk rotation/extension peak torque: con, ecc, STL) were statistically analyzed by means of the two-factor repeated measures analysis of variance (α = 0.05). Out of 12 possible sessions, athletes participated between 8 and 9 sessions (SMT: 9 ± 3; RT: 8 ± 3; CG: 8 ± 4). Regarding main outcomes of trunk performance, experimental groups showed no significant pre–post difference for maximum trunk strength testing as well as for perturbation compensation (p > 0.05). It is concluded, that future interventions should exceed 6 weeks duration with at least 2 sessions per week to induce enhanced trunk strength or compensatory response to sudden, high-intensity trunk loading in already highly trained adolescent athletes, regardless of training regime.
This scientific paper aimed to examine workplace stressors and factors influencing the Work-Life-Balance of nursing staff to understand potential factors and challenges. The Covid-19-pandemic has only again demonstrated the importance of sufficient and well-educated nursing staff. To ensure this, it is also important to consider the well-being of the nurses, because this influences their job performance, the turnover rate and the number of sick employees. To examine the workplace stressors and the Work-Life-Balance of nursing staff, different theoretical approaches and study findings are taken under consideration to determine their influence on the perceived stress of employees in general and nurses in particular and also the importance of a healthy Work-Life-Balance. The study was conducted by the Declaration of Helsinki and Tokyo. Many different factors make the job as a nurse potentially more stressful than for example administrative occupations. Moreover, there are plenty of difficulties for a healthy Work-Life-Balance for nursing staff and also potential negative effects resulting from a poor Work-Life-Balance or a high amount of workplace stressors. It can be concluded that a solution approach for the workplace stressors and a better Work-Life-Balance can only be reached if the employer and the employees work together to decrease the amount of stress, to offer and learn better mechanisms to cope with stress and to incorporate ways to ensure a better Work-Life-Balance.
Background: The STarT-MSK-Tool is an adaptation of the well established STarT-Back-Tool, used to risk-stratify patients with a wider range of musculoskeletal presentations.
Objective: To formally translate and cross-culturally adapt the Keele STarT-MSK risk stratification tool into German (STarT-MSKG) and to establish its reliability and validity.
Methods: A formal, multi-step, forward and backward translation approach was used. To assess validity patients aged ≥18 years, with acute, subacute or chronic musculoskeletal presentations in the lumbar spine, hip, knee, shoulder, or neck were included. The prospective cohort was used with initial data collected electronically at the point-of-consultation. Retest and 6-month follow-up questionnaires were sent by email. Test-retest reliability, construct validity, discriminative ability, predictive ability and floor or ceiling effects were analysed using intraclass correlation coefficient, and comparisons with a reference standard (Orebro-Musculoskeletal-Pain-Questionnaire: OMPQ) using correlations, ROC-curves and regression models.
Results: The participants’ (n = 287) mean age was 47 (SD = 15.8) years, 51% were female, with 48.8% at low, 43.6% at medium, and 7.7% at high risk. With ICC = 0.75 (95% CI 0.69; 0.81) test-retest-reliability was good. Construct validity was good with correlations for the STarT-MSKG-Tool against the OMPQ-Tool of rs = 0.74 (95% CI 0.68, 0.79). The ability of the tool [comparison OMPQ] to predict 6-month pain and disability was acceptable with AUC = 0.77 (95% CI 0.71, 0.83) [OMPQ = 0.74] and 0.76 (95% CI 0.69, 0.82) [OMPQ = 0.72] respectively. However, the explained variance (linear/logistic regression) for predicting 6-month pain (21% [OMPQ = 17%]/logistic = 29%) and disability (linear = 20%:[OMPQ = 19%]/logistic = 26%), whilst being comparable to the existing OMPQ reference standard, fell short of the a priori target of ≥30%.
Conclusions: The German version of the STarT-MSK-Tool is a valid instrument for use across multiple musculoskeletal conditions and is availabe for use in clinical practice. Comparison with the OMPQ suggests it is a good alternative.
Background: Stratified care has the potential to be efficient in addressing the physical and psychosocial components of low back pain (LBP) and optimise treatment outcomes essential in low-income countries. This study aimed to investigate the perceptions of physiotherapists and patients in Nigeria towards stratified care for the treatment of LBP, exploring barriers and enablers to implementation.
Methods: A qualitative design with semistructured individual telephone interviews for physiotherapists and patients with LBP comprising research evidence and information on stratified care was adopted. Preceding the interviews, patients completed the Subgroups for Targeted Treatment tool. The interviews were recorded, transcribed and analysed following grounded theory methodology.
Results: Twelve physiotherapists and 13 patients with LBP participated in the study (11 female, mean age 42.8 (SD 11.47) years). Seven key categories emerged: recognising the need for change, acceptance of innovation, resistance to change, adapting practice, patient’s learning journey, trusting the therapist and needing conviction. Physiotherapists perceived stratified care to be a familiar approach based on their background training. The prevalent treatment tradition and the patient expectations were seen as major barriers to implementation of stratified care by the physiotherapists. Patients see themselves as more informed than therapists realise, yet they need conviction through communication and education to cooperate with their therapist using this approach. Viable facilitators were also identified as patients’ trust in the physiotherapist and adaptations in terms of training and modification of the approach to enhance its use.
Conclusion: Key barriers identified are the patients’ treatment expectations and physiotherapists’ adherence to the tradition of practice. Physiotherapists might facilitate implementation of the stratified care by communication, hierarchical implementation and utilisation of patients’ trust. Possibilities to develop a consensus on key strategies to overcome barriers and on utilisation of facilitators should be tested in future research.
Background: The extramuscular connective tissue (ECT) has been shown to play a significant role in mechanical force transmission between musculoskeletal structures. Due to this and owing to its tight connection with the underlying muscle, the ECT may be vulnerable to excessive loading. The present study aimed to investigate the effect of eccentric elbow flexor exercise on the morphology of the biceps brachii ECT. In view of the high nociceptive capacity of the ECT, an additional objective was to elucidate the potential relationship between ECT damage and the occurrence of delayed onset muscle soreness (DOMS).
Methods: Eleven healthy participants (♂ = 7; 24 ± 2 years) performed fatiguing dumbbell elbow flexor eccentric exercise (EE) for one arm and concentric exercise (CE) for the other arm in random order and with random arm allocation. Before, immediately after and 24–96 h post-exercise, maximal voluntary isometric contraction torque of the elbow flexors (dynamometer), pressure pain (algometer), palpation pain (100 mm visual analog scale), biceps brachii ECT thickness and ECT/muscle mobility during passive movement (both high-resolution ultrasound) were examined.
Results: Palpation pain, suggestive of DOMS, was greater after EE than CE, and maximal voluntary isometric contraction torque decreased greater after EE than CE (p < .05). Relative to CE, EE increased ECT thickness at 48 (+ 17%), 72 (+ 14%) and 96 (+ 15%) hours post-exercise (p < .05). At 96 h post-EE, the increase in ECT thickness correlated with palpation pain (r = .68; p < .05). ECT mobility was not different between conditions, but compared to CE, muscle displacement increased at 24 (+ 31%), 72 (+ 31%) and 96 (+ 41%) hours post-EE (p < .05).
Conclusion: Collectively, these results suggest an involvement of the ECT changes in delayed onset muscle soreness.