In school education the concept of energy should be a unifying element between all natural science disciplines. Still, many characteristics of living systems appear to be in contradiction to the laws of physics. Physics often refer to energy conservation in a closed system, whereas biology is dominated by open ecological or physiological systems with a "dynamic equilibrium“. This makes the underlying, crosscutting scientific concept of energy hard to understand. Our study investigated, if the idea of an open energy system (with an in- and output of energy), located within an “idealized” closed system (in which the total amount of energy is conserved), offers the potential for a cross-disciplinary understanding. We developed a learning environment and applied interviews to identify students’ ability to think in open and closed systems. Four teaching experiments with focus groups of three students each (9th grade, secondary school, males = 10) were carried out. Within the learning environment a scaled model demonstrated processes in a biogas plant and illustrated the idea of an open system that is in direct exchange with the environment. Students easily described the conversion of energy within the scaled model, but faced severe difficulties when the energy was emitted into the environment. Consequently they showed scientifically wrong conceptions when energy could not be perceived through phenomena anymore. We propose the particle model to illustrate energy and to bridge the apparent macro- microscopic gap.
Aims. To examine one-year changes in oxidative damage and inflammation level in type 2 diabetic patients undergoing behavioral treatment for subsyndromal depression. Materials and Methods. A randomized controlled comparison of psychoeducation (A), physical exercise (B), and enhanced treatment as usual (C) was performed in 209 eligible subjects in a tertiary diabetes care setting. Depressive symptoms (primary outcome) and selected biomarkers of oxidative damage and inflammation (secondary outcomes) were assessed at baseline and six- and twelve-month follow-up. Results. Out of the 74, 67, and 68 patients randomised into groups A, B, and C, respectively, 201 completed the interventions, and 179 were analysed. Participants in all three groups equally improved in depressive symptoms from baseline to one-year follow-up (repeated measures ANOVA; F = 12.51, p < 0.0001, η (2) = 0.07). Urinary 8-oxo-deoxyguanosine (u-8-oxodG) decreased (F = 10.66, p < 0.0001, η (2) = 0.06), as did sialic acid and leukocytes (F = 84.57, η (2) = 0.32 and F = 12.61, η (2) = 0.07, resp.; p < 0.0001), while uric acid increased (F = 12.53, p < 0.0001, η (2) = 0.07) in all subjects during one year. Improvement of depressive symptoms at 6 months significantly predicted one-year reduction in u-8-oxodG (β = 0.15, p = 0.044). Conclusion. Simple behavioral interventions are capable not only of alleviating depressive symptoms, but also of reducing the intensity of damaging oxidative/inflammatory processes in type 2 diabetic patients with subsyndromal depression. This trial is registered with ISRCTN05673017.
Contemporary office work is becoming increasingly challenging as many routine tasks are automated or outsourced. The remaining problem solving activities may also offer potential for lifelong learning in the workplace. In this study, we analyzed problem solving in an office work setting using an Internet-based, semi-standardized diary to collect data close to the process. Thirteen employees in commercial departments of an automotive supplier participated voluntarily; they recorded 64 domain-specific problem cases in total. Typical problems were moderately complex but rather urgent. They were detected by means of monitoring, augmented feedback or feedback from others. The problems detected provoked states of high arousal, including both negative and positive emotions. We found that seeking support from others was the most common approach to problem solving, and that in general problem solving offered considerable learning possibilities. Experts were confronted with more complex problems than novices, they more often solved problems using their domain-specific knowledge, but they also preferred social support. Surprisingly, experts reported higher negative emotional states after having detected a problem than novices. The results, the diary method and the limitations of the study are discussed.
Background: Elevated depressive symptoms that do not reach criteria for a clinical diagnosis of depression are highly prevalent in persons with diabetes. This study was aimed at determining the efficacy of psychoeducation and physical exercise compared with enhanced treatment as usual on 1-year changes in depressive symptoms, diabetes distress and self-management, and quality of life and metabolic control in type 2 diabetes patients with subsyndromal depression.
Methods: Adult type 2 diabetes patients who screened positively for depression and expressed a need for professional help with mood-related issues were eligible. Exclusion criteria were clinical depression, current psychiatric treatment and advanced diabetes complications. Out of 365 eligible patients 209 consented to either 6 weekly sessions of psychoeducation (A) and physical exercise (B), or to enhanced treatment as usual (C). Computer-generated sequences for block randomisation stratified by gender were used. Depressive symptoms (primary outcome) and diabetes distress, diabetes self-care, metabolic control and health-related quality of life(secondary outcomes) were analysed at 6-month and 12-month follow-up using repeated-measures ANOVAs.
Results: Out of the 74 patients randomised into group A, 66 into B and 69 into group C, 203 completed the interventions, and 179 patients with all 3 assessments were analysed. Depressive symptoms in participants from the psychoeducational, physical exercise and the enhanced treatment as usual groups improved equally from baseline to 12-month follow-up (time versus time x group effect; F = 12.51, p < 0.001, η2 = 0.07 and F = 0.609, p = 0.656, η2 = 0.007 respectively), as did diabetes distress and quality of life (all p < 0.001), diabetes self-care (p < 0.001 to < 0.05), triglycerides, and total cholesterol and LDL-cholesterol (p < 0.001).
Conclusions: The employed interventions had comparable positive effects on 12-month psychological and diabetes related outcomes suggesting that even minimal intervention addressing patients’ diabetes-related problems and concerns had favourable clinical implications and might be sufficient to treat subsyndromal depression. Further investigation is warranted to clarify possible mechanisms of improvement.
Temperature changes on the surface of the skin lead to modifications of subcutaneous microcirculation. This phenomenon
is employed in a standardized way by the InsuPad device to stabilize skin conditions before injections, which is associated
with enhanced prandial insulin absorption. Three programmed warming cycles to 40°C within 50 minutes are resulting in
faster insulin appearance in the plasma. Early standardized meal tolerance studies indicated a substantial improvement in
postprandial glucose control when the same short-acting insulin analog dose was applied using InsuPad, and a dose reduction
by 20% resulted in comparable glucose excursions. Similar results were obtained when patients applied the device under realworld
conditions for 1 month. The InsuPad device was also tested in a prospective, controlled, parallel 3-month real-world
study with 145 well-controlled but insulin-resistant patients with type 1 or type 2 diabetes. Patients were treated to target in
both treatment arms (6.2 ± 0.5% in each group), with or without the device. However, patients with InsuPad needed 28% less
prandial insulin, needed 12.5% less total insulin, and had 46% less confirmed hypoglycemic events (blood glucose < 63 mg/dL)
as compared to the control group. Except for very few inflammatory or allergic skin reactions, there were no device-specific
adverse events reported from these studies. In conclusion, use of InsuPad when applying prandial insulin doses may result in
a safer and more efficient treatment of type 1 or type 2 diabetes.