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Background:
With the prevalence of burnout among surgeons posing a significant threat to healthcare outcomes, the mental toughness of medical professionals has come to the fore. Mental toughness is pivotal for surgical performance and patient safety, yet research into its dynamics within a global and multi-specialty context remains scarce. This study aims to elucidate the factors contributing to mental toughness among surgeons and to understand how it correlates with surgical outcomes and personal well-being.
Methods:
Utilizing a cross-sectional design, this study surveyed 104 surgeons from English and German-speaking countries using the Mental Toughness Questionnaire (MTQ-18) along with additional queries about their surgical practice and general life satisfaction. Descriptive and inferential statistical analyses were applied to investigate the variations in mental toughness across different surgical domains and its correlation with professional and personal factors.
Results:
The study found a statistically significant higher level of mental toughness in micro-surgeons compared to macro-surgeons and a positive correlation between mental toughness and surgeons' intent to continue their careers. A strong association was also observed between general life satisfaction and mental toughness. No significant correlations were found between the application of psychological skills and mental toughness.
Conclusion:
Mental toughness varies significantly among surgeons from different specialties and is influenced by professional dedication and personal life satisfaction. These findings suggest the need for targeted interventions to foster mental toughness in the surgical community, potentially enhancing surgical performance and reducing burnout. Future research should continue to explore these correlations, with an emphasis on longitudinal data and the development of resilience-building programs.
The utilization of virtual reality (VR) technology has shown promise in various therapeutic applications, particularly in exposure therapy
for reducing fear of certain situations objects or activities, e.g. fear of height, or negative evaluation of others in social situations. VR has been shown to yield positive outcomes in follow-up studies, and provides a safe and ecological therapeutic environment for therapists and their patients. This paper presents a collaborative
effort to develop a VR speech therapy system which simulates a virtual audience for users to practice their public speaking skills. We describe a novel web-based graphica user interface that enables
therapists to manage the therapy session using a simple timeline. Lastly, we present the results from a qualitative study with therapists and teachers with functional dysphonia, which highlight the potential of such an application to support and augment the therapists’ work and the remaining challenges regarding the design of natural interactions, agent behaviours and scenario customisation for patients.
Hintergrund/Zielsetzung
Der Beitrag befasst sich mit dem Wissenstand und der Einstellung der Bevölkerung. Betrachtet werden die Übermittlung und Verfügbarkeit von Gesundheitsdaten, Gesundheitsregister, die elektronische Patientenakte, Einwilligungsverfahren für die Übermittlung von Daten und der Zugriff auf Gesundheitsdaten zu Forschungszwecken.
Methoden
Die Studie basiert auf einer computergestützten Telefonbefragung (Dual-Frame) bei einer Zufallsstichprobe der Bevölkerung in Deutschland im Zeitraum 01.-27.06.2022 (n = 1.308).
Ergebnisse
Der Wissensstand zur Übermittlung von Gesundheitsdaten an Krankenkassen ist hoch, wohingegen das Vorhandensein zentraler Sterbe-, Impf- und Gesundheitsregister sowie der Zugriff auf Gesundheitsdaten durch behandelnde Ärztinnen und Ärzte überschätzt werden. Die Akzeptanz medizinischer Register ist sehr hoch. Die elektronische Patientenakte ist bei der Hälfte der Bevölkerung unbekannt, die Nutzungsbereitschaft ist eher gering ausgeprägt; bei der Übertragung von Daten wird eine Zustimmungsoption bevorzugt, und über achtzig Prozent würden die Daten der elektronischen Patientenakte zur Forschung freigeben. Drei Viertel würden ihre Gesundheitsdaten allgemein zur Forschung freigeben, insbesondere an Universitäten in Deutschland, wobei meist Anonymität Bedingung ist. Die Bereitschaft zur Datenfreigabe steigt mit der Höhe des Vertrauens in die Presse sowie in Universitäten und Hochschulen, und sie sinkt, wenn ein Datenleck als schwerwiegend erachtet wird.
Diskussion und Schlussfolgerung
In Deutschland besteht, wie in anderen europäischen Ländern, eine große Bereitschaft zur Freigabe von Gesundheitsdaten zu Forschungszwecken. Dagegen ist der Wunsch zur Nutzung der elektronischen Patientenakte eher gering. Ebenso niedrig ist die Akzeptanz einer Widerspruchsoption, die jedoch als Voraussetzung für eine erfolgreiche Einführung einer elektronischen Patientenakte gilt. Vertrauen in die Forschung und staatliche Stellen, die Gesundheitsdaten verarbeiten, sind zentrale Faktoren.
Right-wing populism challenges the societies in Europe. The rise of such movements and parties are a threat to peace and democracy in Germany. This article focuses the possibilities as well as the boundaries of political education under the current circumstances. To this end, it discusses theoretical explanations based on approaches in peace education, political didactics and social sciences to deal with right-wing populism in practice. (DIPF/Orig.).
Im Verlauf der Covid-19-Pandemie war in Gesellschaft, Politik und Wissenschaft immer wieder von einer "Krise der Demokratie" die Rede. Diese "Krise der Demokratie" ist auch eine "Krise der Repräsentation": Reale Politik wird hinter verschlossenen Türen gemacht - und das im Eiltempo -, die Mehrheit der Bürger*innen spielt eine passive Rolle. Politische Erwachsenenbildung hat die Aufgabe, diese Krise zu diskutieren. Allerdings befindet sie sich selbst schon seit Längerem in einer Krise: In ihrer Heterogenität fehlt ihr eine Standortbestimmung, die Übergänge zur non-formalen Bildung und schulischen politischen Bildung, aber auch zu anderen Professionen sind fließend. Darüber hinaus gibt es noch kein einheitliches Profil hinsichtlich Professionalität in der politischen Erwachsenenbildung, kein einheitliches Berufsbild, keine einheitliche Aus-, Fort- oder Weiterbildung und auch keine einheitliche Didaktik. Nicht zuletzt fehlt es an stetiger Finanzierung politischer Bildung und die Teilnahmequoten liegen deutlich hinter anderen Weiterbildungsbereichen zurück. An Ansatzpunkten zur Krisenbewältigung fehlt es also nicht.
Das Krankheitsbild der „Frozen Shoulder“ gibt nach wie vor viele Rätsel auf. Um den aktuellen Stand der Erkenntnisse zu Ätiologie, Diagnostik und Behandlung darzustellen und den dabei beteiligten Berufsgruppen Handlungsempfehlungen zu bieten, wurde von der DGOU und der DVSE eine Arbeitsgruppe gebildet, die eine deutschsprachige, evidenzbasierte Leitlinie erstellt hat, die 2022 bei der AWMF veröffentlicht wurde. Im Folgenden werden die Entstehung und die wichtigsten Ergebnisse zusammengefasst.
BACKGROUND
Surgeons have historically used age as a preoperative predictor of postoperative outcomes. Sarcopenia, the loss of skeletal muscle mass due to disease or biological age, has been proposed as a more accurate risk predictor. The prognostic value of sarcopenia assessment in surgical patients remains poorly understood. Therefore, we aimed to synthesize the available literature and investigate the impact of sarcopenia on peri- and postoperative outcomes across all surgical specialties.
METHODS
We systematically assessed the prognostic value of sarcopenia on postoperative outcomes by conducting a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching the PubMed/MEDLINE and EMBASE databases from inception to 1st October 2022. Our primary outcomes were complication occurrence, mortality, length of operation and hospital stay, discharge to home, and postdischarge survival rate at one, three, and five years. Subgroup analysis was performed by stratifying complications according to the Clavien-Dindo classification system. Sensitivity analysis was performed by focusing on studies with an oncological, cardiovascular, emergency, or transplant surgery population, and on those of higher quality or prospective study design.
RESULTS
A total of 294 studies comprising 97,643 patients, of which 33,070 had sarcopenia, were included in our analysis. Sarcopenia was associated with significantly poorer postoperative outcomes including greater mortality, complication occurrence, length of hospital stay, and lower rates of discharge to home (all P<0.00001). A significantly lower survival rate in patients with sarcopenia was noted at one, three, and five years (all P<0.00001) after surgery. Subgroup analysis confirmed higher rates of complications and mortality in oncological (both P<0.00001), cardiovascular (both P<0.00001), and emergency (P=0.03 and P=0.04, respectively) patients with sarcopenia. In the transplant surgery cohort, mortality was significantly higher in patients with sarcopenia (P<0.00001). Among all patients undergoing surgery for inflammatory bowel disease, the frequency of complications was significantly increased among sarcopenic patients (P=0.007). Sensitivity analysis based on higher-quality studies and prospective studies showed that sarcopenia remained a significant predictor of mortality and complication occurrence (all P<0.00001).
CONCLUSION
Sarcopenia is a significant predictor of poorer outcomes in surgical patients. Preoperative assessment of sarcopenia can help surgeons to identify patients at risk, critically balance eligibility, and refine perioperative management. Large-scale studies are required to further validate the importance of sarcopenia as a prognostic indicator of perioperative risk, especially in surgical sub-specialties.
The elite sport movement for athletes with hearing impairments, namely Deaflympics, differs from the Paralympic and Olympic sport movements because it exhibits a variety of distinct sociocultural and organisational characteristics. Yet, mental training with Deaflympic athletes receives little to no attention from the scientific community. Little is known about sport psychology consultants’ (SPCs) work with Deaflympic athletes. In this study, we explored SPCs’ exposure to so called Deaf sport as well as their experiences, attitudes, and assumptions regarding the utility of psychological skills training (PST) with Deaflympic athletes. A self-constructed questionnaire with closed and semi-open questions was completed by 93 (58.8% female) SPCs in European German-speaking countries. Analyses revealed SPCs had limited exposure to Deaflympic sport but indicated readiness to work with Deaflympic athletes. SPCs shared no reasons as to why PST skills and techniques would not be effective with Deaflympic athletes. However, SPCs regarded communication challenges as a major obstacle. We conclude that the integration of elite Deaf sport in SPCs’ training programmes is vital, considering SPCs’ lack of exposure and experience with Deaflympic athletes as well as their communication insecurities. In addition, further empirical research on PST effectiveness in Deaflympics athletes should provide the foundation for evidence-based utility of applied sport psychology in Deaflympic sport.
Die Situation von Menschen im Pflegeheim, die besonders dem Risiko der „pflegebedingten Verarmung“ ausgesetzt sind, ist in der Forschung wenig präsent. Der Beitrag befasst sich mit dem Erleben von Unsicherheiten, Armut und prekären Lebenslagen älterer Menschen im Heim. Grundlage liefern Daten einer ethnographischen Studie zum Älterwerden und zum Leben mit chronischen Erkrankungen. Anhand von Fällen wird ein Spektrum prekärer Lebenslagen skizziert. Deutlich wird u. a.: Menschen mit diversen soziobiografischen Hintergründen können im Zuge von Hilfebedürftigkeit und Heimübergängen von Unsicherheiten, Armut und prekären Lebenslagen betroffen sein. Nicht zu wissen, ob das verfügbare Geld genügt, um Kostensteigerungen bis zum Lebensende zu decken, kennzeichnet eine häufig erlebte Zukunftsunsicherheit; drohende Armut bzw. die Abhängigkeit von Sozialhilfe können pflege- und institutionell bedingte Verlusterfahrungen von Autonomie, Teilhabe und Lebensgestaltung verschärfen und den Gesamtzustand weiter destabilisieren. Das Erleiden bleibt weitgehend unsichtbar; strukturelle Probleme werden individualisiert.
Background:
People with aphasia (PWA) often suffer from reduced participation and quality of life. Nevertheless, there are currently only a few specific interventions that respond to this problem. Participation and quality of life could be increased by interacting with peers who have similar experiences. Digital social networks could stimulate an autonomous interaction. However, digital social networks need to be adapted to the specific needs of PWA. Therefore, a participatory, agile process involving the target group should be chosen to develop such a olution, i.e., an app. The research project consists of a total of three phases. In the first phase—app development—the app was developed and programmed including the target group. In the second phase—app testing—the usability and user-friendliness of the app were evaluated with four PWA. In the third phase—feasibility and preliminary effcacy—that will be described in the article, the impact of the app on PWA will be evaluated.
Aims:
The overarching aim of our study is to provide preliminary effcacy of the intervention. Digital social interaction with other PWA can lead to increased social integration. In addition to digital interaction, personal encounters between PWA should be encouraged. As a result, we expect an improvement in quality of life of PWA. Additionally, we focus on identification of the most appropriate measurements to discover changes associated with the intervention.
Methods:
The evaluation, which is described in this paper, takes place in a pre-test - post-test design with a total of n = 48 PWA. Participants will be recruited in regional clusters to facilitate face-to-face meetings. Half of the participants will be assigned to the delayed intervention group and the other half to the immediate intervention group. Participants in the delayed intervention group will go through a 3-month waiting period before using the app, while the participants of the immediate intervention group will start using the app for 3 months right away. Inclusion criteria are the presence of chronic aphasia (at least 6 months) and possession of a smartphone with internet access. Questionnaires on quality of life (SAQOL-39, GHQ-12), depression (GDS, DISCs), communicative participation (CPIB), and social support (F-SozU) will be conducted at inclusion (t0), after 3 months of app use (t1), and after another 3 months for follow-up (t2). Participants in the delayed intervention group will be assessed twice before the intervention, before the 3-month waiting period (t0a) and after the waiting period (t0b). In addition to the quantitative measures, interviews will take place with 6 to 8 selected participants after 3 months of app use. Responses will be analysed using Thematic Analysis.
Discussion:
The app will be the first social network tool that is systematically developed with PWA. Initial indications from the first phases are that the app can be used by PWA, so that the evaluation of this app version can take place in the third phase. Results of this study can provide an initial indication of whether social network support is a suitable intervention. Findings will help provide information on the feasibility of digital connectivity for PWA. Preliminary findings on its impact on the participation and quality of life of PWA could be made available.
Ziel der Studie:
Ziel der Studie ist die Messung des Stands der Digitalisierung und die mit einer Anbindung an die Telematikinfrastruktur verbundenen Chancen und Herausforderungen für Rehabilitationseinrichtungen.
Methodik:
Teilstandardisierte Online-Befragung bei Trägern von Rehabilitationseinrichtungen in Bayern (n=33). Der Fragebogen mit 36 Fragen beinhaltet eine leicht veränderte Skala auf Basis des „Electronic Medical Record Adoption Model (EMRAM)“.
Ergebnisse:
Der Digitalisierungsgrad wurde in 70 Prozent der Rehabilitationseinrichtungen mit Stufe 0 angegeben (Stufenmodell bis 7). Die Übermittlung patientenbezogener Daten (Eingang und Ausgang) erfolgt häufig analog, wohingegen die Verarbeitung innerhalb der Einrichtung in vielen Fällen bereits überwiegend digital ist. Beim Anschluss an die Telematikinfrastruktur wird hoher Aufwand bei der Installation, aber auch der Schulung des Personals und der Anpassung der Arbeitsorganisation gesehen.
Schlussfolgerung:
Durch Änderung der gesetzlich-finanziellen Lage in Deutschland eröffnen sich für Rehabilitationseinrichtungen neue Möglichkeiten einer verstärkten Digitalisierung. Hürden hängen mit Anforderungen an IT-Sicherheit, Schulung des Personals und sowie dem ebenfalls geringen Digitalisierungsstand bei Krankenhäusern und Ärzt*innen sowie Patient*innen zusammen, die eine digitale Datenübermittlung erschweren.
The study is based on a German single-topic population survey on vaccination willingness against COVID-19 (VWC) by the authors (2020, n = 2014). The single-topic survey allowed us to test several competing explanations for VWC, as discussed in the literature. The VWC in the sample was 67.3%. Logistic regression was used to identify factors affecting VWC. Being at high risk from COVID-19 and having received flu vaccination have a positive impact on VWC. Perceived VWC of friends has a strong positive effect on respondents’ VWC. Bivariate relationships of gender, age, and level of education with VWC were no longer significant in a multivariate analysis. Trust in alternative medicine and belief in conspiracy theories have a negative effect on VWC.
Im Rahmen des Projektes AUT-1A wurden 123 Arbeitgeber*innen mittels Fragebogen zu ihren Erfahrungen mit der Beschäftigung von autistischen Mitarbeiter*innen befragt. Ziel war es, die beschäftigungsfördernden und -hindernden Faktoren herauszuarbeiten. Die Studie deutet darauf hin, dass sich die berufliche Qualifizierung in den Berufsbildungswerken positiv auf die nachhaltige Beschäftigung von Menschen mit Autismus-Spektrum-Diagnose (ASD) auswirkt, die Unterstützungsleistungen für Betriebe aber noch nicht hinreichend sind. Auch konnte eine mangelnde Aufklärung in Bezug auf eine autismusfreundliche Umgebungsgestaltung sowie eine mangelnde Aufklärung über die Diagnose Autismus der direkten Kolleg*innen herausgearbeitet werden.
As part of the AUT-1A project, 123 employers were surveyed by questionnaires about their experiences with the employment of autistic employees. The aim was to identify the factors that promote and hinder employment. The study indicates that the vocational qualification in vocational training centers (BBW) has a positive effect on sustainable employment of people with autism spectrum diagnosis (ASD), but the support for companies is not sufficient yet. Also, a lack of education regarding autism-friendly environmental design as well as a lack of education about the diagnosis autism of the direct colleagues could be worked out.
Older adults in long-term care homes are at high risk of experiencing
reduced quality of life (QoL) and depression. Technology-assisted biography work can have a positive impact on QoL and mood, but there is little research on its use with this target group. The purpose of this paper is to examine the effect of tablet-based biography work conducted by volunteers on the QoL of residents and volunteers. A pretest-posttest control group design with an intervention period of 3 months and a 3-month follow-up was used. Results show a significant increase in participation for volunteers and residents after
the intervention, which is stable for residents until follow-up. Volunteers also show significant improvement in mental QoL immediately after the intervention. There were no significant effects for life satisfaction, self-esteem, or depression. No significant changes were found for the control group. Digitally conducted tablet-based biography work appears to have effects on QoL-associated outcomes.
Im Rahmen des Projektes AUT-1A wurden 123 Arbeitgeber*innen mittels Fragebogen zu ihren Erfahrungen mit der Beschäftigung von autistischen Mitarbeiter*innen befragt. Ziel war es, die beschäftigungsfördernden und -hindernden Faktoren herauszuarbeiten. Die Studie deutet darauf hin, dass sich die berufliche Qualifizierung in den Berufsbildungswerken positiv auf die nachhaltige Beschäftigung von Menschen mit Autismus-Spektrum-Diagnose (ASD) auswirkt, die Unterstützungsleistungen für Betriebe aber noch nicht hinreichend sind. Auch konnte eine mangelnde Aufklärung in Bezug auf eine autismusfreundliche Umgebungsgestaltung sowie eine mangelnde Aufklärung über die Diagnose Autismus der direkten Kolleg*innen herausgearbeitet werden.
Three-dimensional Medical Printing and Associated Legal Issues in Plastic Surgery: A Scoping Review
(2023)
Three-dimensional printing (3DP) represents an emerging field of surgery. 3DP can facilitate the plastic surgeon’s workflow, including preoperative planning, intraoperative assistance, and postoperative follow-up. The broad clinical application spectrum stands in contrast to the paucity of research on the legal framework of 3DP. This imbalance poses a potential risk for medical malpractice lawsuits. To address this knowledge gap, we aimed to summarize the current body of legal literature on medical 3DP in the US legal system. By combining the promising clinical use of 3DP with its current legal regulations, plastic surgeons can enhance patient safety and outcomes.
217 Teilnehmer/innen wurden mittels standardisierter Fragebögen zu ihrer Informiertheit über das Hilfesystem bei Demenz sowie zu ihren eigenen Versorgungswünschen im Falle einer Demenzerkrankung befragt. Bei den Probanden handelt es sich um Personen mit und ohne pflegebedürftige Angehörige. Jene wurden hinsichtlich ihrer Versorgungssituation in drei Gruppen unterteilt: ambulante Pflege, Tagespflege und Altenpflegeheime. Die Ergebnisse zeigen, dass in allen Untersuchungsgruppen ein im Allgemeinen geringer Informationsstand in Bezug auf die unterschiedlichen Hilfs- und Entlastungsangebote für Angehörige dementer Patienten vorherrscht. Zu den bevorzugten Versorgungsformen im Falle eigener Betroffenheit gehören ambulante sowie neue, alternative Pflegemodelle.
Durch die voranschreitende Digitalisierung bieten sich neue Ansätze für Designs und Methoden in der Jugendforschung. Mit vielfältigen digitalen Möglichkeiten wachsen auch Chancen für inklusiv angelegte Befragungen. Dieser Beitrag fokussiert exemplarisch gehörlose bzw. hörbeeinträchtigte gebärdensprachige Jugendliche und stellt nach einem theoretischen und empirischen Überblick die Frage, ob und inwieweit diese heterogene Gruppe Jugendlicher durch in digitale Fragebögen implementierte Videos in Gebärdensprache profitieren kann. Anhand zweier kontrastiver Fallvignetten sollen Erfahrungen aus dem Projekt „Inklusive Methoden“ in Bezug auf Möglichkeiten, Voraussetzungen, Herausforderungen und Grenzen digitaler Befragungen mit Gebärdensprachvideos dargestellt und diskutiert werden.
Steigende Fallzahlen von Menschen mit Demenz, der komplexe Bedarf und eine unzureichende Versorgungsrealität erfordern innovative und nachhaltige Lösungsansätze. Der Beitrag stellt ein Versorgungsmodell für Menschen mit Demenz vor, das infolge akuter Versorgungsprobleme entwickelt wurde und das eine umfassende, patientenorientierte Versorgung über Sektorengrenzen hinweg umsetzt. Beschrieben werden Struktur und Bedingungen gelingender Kooperation und umfassender Versorgung.
Old wine in new wineskins?
(2013)
In the mid 2000s, a fundamental labour market reform has been carried out in Germany. The so-called Hartz-reforms were supposed to implement the paradigms of “activation” and “individual responsibility”. It was also discussed, whether in this context the “adult worker model” and more gender equality in the labour market should and could be achieved. This article clarifies the reforms ambivalent impact on women: there is a stronger but only partial labour market inclusion predominantly into the low-wage sector. Women´s responsibility in private care remains unchanged. Besides, in both fields, gender equality is not only a matter of quantity but also of quality. In other words, it is not about work inclusion at any cost, but rather the circumstances for female employment must be critically analyzed. The labour market reforms have so far done little to oppose the gender specific structures of the labour market.
The professional requirements in Software Engineering have become highly volatile due to the complexities of project development and rapid and innovative changes occurring in the field. Therefore, the development of inter-personal and social competences has gained central importance in the training of software developers. This paper will present a concept allowing to acquire competences by using Case Method and Role Play as instruments in several lectures of Software Engineering. By approaching the issue of competence acquisition on a technical as well as on an educational and social level, life-long learning is facilitated and supported.
The purpose of this study was to empirically analyze the sports background, personality dimensions, attitudes, and social competencies of adult head coaches and young assistant coaches involved in the German Einfach Fußball ( Just Soccer) program, which promotes the participation of pupils with intellectual disabilities in soccer/sports and society. Methods. The study recruited 28 head coaches and 29 assistant coaches who completed a questionnaire battery of standardized instruments (NEO Five-Factor Inventory, Interpersonal Reactivity Index, Social Self-Efficacy) as well as self-developed instruments. Analysis of the data involved descriptive and inferential statistical procedures. A descriptive comparison of the assistant coaches with a normative sample of males aged 16–20 years was performed. Results. The head coaches were found with little soccer/sports experience with persons with disabilities prior to participation in the Just Soccer program. However, the majority were familiar with these persons through personal/vocational contacts. Overall, the head coaches were differentiated by formal coaching levels and playing backgrounds, with very few holding any additional formal qualifications in special education. The assistant coaches pre
sented below average scores in the analyzed five personality dimensions when compared with the normative sample. Their attitudes
and social competencies did not change during their 8-month involvement in Just Soccer . Conclusions. The findings highlight
the important role of the coaching staff in the success of the Just Soccerprogram. coaches involved in such activities should be familiarized with needs of people with disabilities, be stress-resistant, and possess a balanced set of personality traits. In addition, the results suggest that such individuals should be coaches/players from conventional soccer clubs instead of special school physical education teachers.
The American Board of Internal Medicine (ABIM) Foundation launched the Choosing Wisely campaign in 2012 and until today convinced more than 50 US specialist societies to develop lists of interventions that may not improve people’s health but are potentially harmful. We suggest combining these new efforts with the already existing efforts in clinical practice guideline development. Existing clinical practice guidelines facilitate a more participatory and evidence-based approach to the development of top 5 lists. In return, adding top 5 lists (for overuse and underuse) to existing clinical practice guidelines nicely addresses a neglected dimension to clinical practice guideline development, namely explicit information on which Do or Don’t do recommendations are frequently disregarded in practice.
Sport im Strafvollzug
(2011)
Purpose
The purpose of this study was to gather data about physical activity and quality of life (QoL) for people of working age with visual impairments to optimize upcoming physical activity-based interventions in vocational rehabilitation.
Methods
Two hundred and seventy-seven former participants of four vocational rehabilitation centres in Germany answered an online questionnaire. The health-related QOL has been assessed by means of the WHOQOL-BREF questionnaire. The data were analysed via multivariate analysis of covariances (MANCOVAs), univariate analysis of covariances (ANCOVAs) and discriminant function analysis.
Results
Compared to a normative group of adults aged 36-45, the study group showed lower values in all domains of QOL. The MANCOVA (visual acuity) produced no multivariate significant effect. Also, the ANCOVA showed no significant effect for the global dimension of the WHOQOL-BREF. The MANCOVA (leisure time activity) produced a multivariate significant effect. Post-hoc ANCOVAS revealed significant effects for all four domains of QoL. The ANCOVA analysing the global domain showed a similar significant effect as well. The active persons had higher values in all domains of QoL compared to the more passive participants.
Conclusion
Interventions in vocational rehabilitation should focus on leisure time activity to enhance QoL. At this stage, the role of physical activity is still unclear and further studies are needed.
Implications for rehabilitation People with visual impairments often show a worse quality of life than normal-sighted people.
The degree of severity of the visual impairment does not affect quality of life.
Sport and physical activity are effective means of improving quality of life.
An active leisure time activity supports the improvement of the quality of life of visual-impaired people that participated in a vocational rehabilitation.
In der Vergangenheit wurde beklagt, dass in der empirischen Forschung zur Bildungsbeteiligung Erwachsener selten eine Integration von Theorie und Empirie erfolge und die mangelnde empirische Prüfung eine theoretische Weiterentwicklung des Forschungsfeldes erschwere. Mittels einer Qualitativen Inhaltsanalyse von Beiträgen ausgewählter Fachzeitschriften der Erwachsenen‑/Weiterbildungsforschung wurde versucht, die Aktualität dieser Feststellung empirisch zu überprüfen. Dazu wurden 38 empirische Forschungsbeiträge zur Bildungsbeteiligung der Jahrgänge 2018 bis 2020 von neun Fachzeitschriften mit Peer-Review untersucht. Die Einschätzung der Beiträge erfolgte hinsichtlich des Grades der Theorieeinbindung. Die Ergebnisse der Analyse zeigen ein gemischtes Bild: neun Beiträge (24 %) binden keine Theorie in den Forschungsprozess ein, ein Beitrag (3 %) zitiert Theorie lediglich, ohne sie weiter einzubinden. Am häufigsten ist eine Einbindung zum theoriegeleiteten Vorgehen (16 Beiträge, 42 %). Eine tiefergehende Theorieanwendung findet sich in sechs Beiträgen (16 %). Eine theorieprüfende oder -bildende Einbindung liegt mit je drei Beiträgen (je 8 %) seltener vor. Die rezipierten Theorien sind vielfältig: es werden 20 verschiedene Theorieansätze festgestellt. Den Forderungen nach einer verstärkten Einbindung von Theorie in den Forschungsprozess kann somit weiterhin Gültigkeit attestiert werden: ein substanzieller Teil der Beiträge berichtet keine Theorieeinbindung, eine empirische Prüfung oder Weiterentwicklung findet relativ selten statt.
Thinking like a Lawyer - Human Rights and Their Association with the Plastic Surgeon of Today
(2022)
Plastic surgeons are trained to perform a wide repertoire of surgeries-ranging from standard local procedures to highly specialized operations. Therefore, plastic surgeons treat a plethora of clinical presentations and address multiple patient needs. Their daily workflow is increasingly entwined with legal topics. The concrete legal
interpretation falls within the remit of legal experts.
However, by understanding the legal basics of selected surgical procedures, plastic surgeons may generate synergies in patient care and clinical practice. The legal situation is to be elucidated based on the German Basic Law (GBL) and the European Convention on Human Rights
(ECHR).
Physical Education with Eduball Stimulates Non-Native Language Learning in Primary School Students
(2022)
Although the neuronal mechanisms of action and cognition are related, the division of intellectual and physical lessons is standard in schools. This is surprising, because numerous studies show that integrating physical education (PE) with teaching content stimulates critical skills. For example, several experiments indicate that Eduball-based PE (i.e., lessons in a sports hall during which students play team mini-games with educational balls with printed letters, numbers, and other signs) develops mathematical and language competencies. At the same time, the Eduball method does not slow down learners' physical development. However, we have little knowledge about the effects of such techniques on non-native language learning. Consequently, the absence of incorporating core academic subjects into PE in dual-language schools or during foreign language education is exceptionally high. Here, we replicated the Eduball experiment, but with the goal of testing this method for non-native language learning. Thus, the intervention occurred in a dual-language primary school and we evaluated second language (L2) learning. As before, we used the technique of parallel groups (experimental and control); in both groups, there were three 45-min PE classes per week. In the experimental class, two of them were held using Eduball. After a half-year experiment, children from the experimental group (one second-grade, N = 14) improved their non-native language skills significantly more than their peers from the control group (one second-grade, N = 12). These findings demonstrate that Eduball-type intervention stimulates non-native language learning in children. Hence, our report suggests that specific body training forms can support L2 learning.
Hintergrund
Inhalte von Public Health werden in Deutschland in gesundheitsbezogenen Studiengängen an Hochschulen und Universitäten gelehrt. Ziel dieser Studie war es, Daten zur Lehre und zur Kooperation von Lehrenden von Public Health in gesundheitsbezogenen Studiengängen in Deutschland zur Verfügung zu stellen.
Methode
Eine Querschnittsuntersuchung wurde online-basiert vom 01.06. bis 15.09.2015 an 93 Hochschulen/Universitäten in Deutschland mit 351 Studiengangsverantwortlichen aus gesundheitsbezogenen Studiengängen durchgeführt. Einbezogen wurden Public Health Studiengänge und gesundheitsbezogene Studiengänge, deren Hochschulen bzw. Universitäten entweder Mitglied in der "Deutschen Gesellschaft für Sozialmedizin und Prävention" (DGSMP) oder in der Gesellschaft "Hochschulen für Gesundheit" (HOGE) sind. Teilgenommen an dieser Studie haben N=104 Studiengangsverantwortliche (43% Männer, 57% Frauen). In Public Health Studiengängen wurden „Global Health" und "Umwelt und Gesundheit" als Studieninhalte häufiger als in gesundheitsbezogenen Studiengängen benannt; in gesundheitsbezogenen Studiengängen wurden häufiger "Ethik" und "Gesundheitspsychologie" als Lehrinhalte benannt. Finanzielle Unterstützungen durch die Hochschulen/ Universitäten sowie strukturierte Partnerschaften zwischen Hochschulen und/ oder Universitäten werden von Lehrenden an Hochschulen (36%) und an Universitäten (40%) gewünscht. Lehrende an Hochschulen wünschen darüber hinaus Promotionspartnerschaften.
Schlussfolgerung
Bisher gibt es in Deutschland keine einheitlichen fachlichen Qualitätskriterien für Absolvierende von Public Health bzw. gesundheitsbezogenen Studiengängen. Zudem gibt es nach Aussage der Studiengangsverantwortlichen dieser Studiengänge wenig Kooperation zwischen Lehrenden der Public Health bzw. der gesundheitsbezogenen Studiengänge.
The main focus of this paper is to describe the development and current state of policy, research and implementation of patient-centered care (PCC) and shared decision-making (SDM) in Germany. What is the current state in health policy? Since 2013, the Law on Patients' Rights has standardized all rights and responsibilities regarding medical care for patients in Germany. This comprises the right to informed decisions, comprehensive and comprehensible information, and decisions based on a clinician-patient partnership. In addition, reports and action plans such as the German Ethics Council's report on patient well-being, the National Health Literacy Action Plan, or the National Cancer Plan emphasize and foster PCC and SDM on a policy level. There are a number of public organizations in Germany that support PCC and SDM. How are patients and the public involved in health policy and research? Publishers and funding agencies increasingly demand patient and public involvement. Numerous initiatives and organizations are involved in publicizing ways to engage patients and the public. Also, an increasing number of public and research institutions have established patient advisory boards. How is PCC and SDM taught? Great progress has been made in introducing SDM into the curricula of medical schools and other health care providers' (HCPs) schools (e.g., nursing, physical therapy). What is the German research agenda? The German government and other public institutions have constantly funded research programs in which PCC and SDM are important topics. This yielded several large-scale funding initiatives and helped to develop SDM training programs for HCPs in different fields of health care and information materials. Recently, two implementation studies on SDM have been conducted. What is the current uptake of PCC and SDM in routine care, and what implementation efforts are underway? Compared to the last country report from 2017, PCC and SDM efforts in policy, research and education have been intensified. However, many steps are still needed to reliably implement SDM in routine care in Germany. Specifically, the further development and uptake of decision tools and countrywide SDM trainings for HCPs require further efforts. Nevertheless, an increasing number of decision support tools - primarily with support from health insurance funds and other public agencies - are to be implemented in routine care. Also, recent implementation efforts are promising. For example, reimbursement by health insurance companies of hospital-wide SDM implementation is being piloted. A necessary next step is to nationally coordinate the gathering and provision of the many PCC and SDM resources available.
Dieser Beitrag enthält Überlegungen zum Rechtspopulismus als (komplexe) Problemstellung der Sozialen Arbeit. Eine theoretisch-reflexive Analyse pädagogischer und didaktischer Ansätze, eine qualitative Analyse zu Herausforderungen und Bewältigungsstrategien von Fachkräften in der Kinder- und Jugendhilfe sowie eine Analyse aktueller Veröffentlichungen und Stellungnahmen im Kontext des Rechtspopulismus legen die Vermutung nahe, dass sich die Soziale Arbeit aufgrund der Komplexität dieses gesellschaftlichen und politischen Phänomens in einer Suchbewegung befindet.
Choosing wisely in Germany - adapting an international initiative to a national healthcare agenda
(2016)
Overuse and underuse in healthcare is a chronic problem in most healthcare systems. Inspired by the North American Choosing Wisely Initiative, the Association of Scientific Medical Societies in Germany (AWMF), which actually counts 173 member organisations, decided to address the problem. The aim of the German “Gemeinsam klug entscheiden” (deciding together wisely)-initiative is to reduce overuse, underuse and misuse of health interventions in areas where recommendations of clinical practice guidelines (CPG) are not adequately implemented or missing. Starting point are the positive and negative recommendations of the CPGs, which the AWMF-member societies have developed for more than 20 years, following the manual and rules set up by AWMF. To identify and select recommendations methodological criteria have been developed by a working group in a consensus-based process. The development of AWMF-CPGs follows a methodology that aims to ensure the full integration of evidence, an interdisciplinary and interprofessional perspective, the prevention of bias as a consequence of conflicts of interest and full transparency of the development process.
In der Literatur fehlen weitgehend empirische Erkenntnisse zum Psychological Skills Training (PST) mit hörbeeinträchtigten Spitzensportler_innen. Die vorliegende empirische Studie analysiert die Anwendbarkeit des TOPS-D1-Fragebogens als geeignetes Diagnostikverfahren für hörbeeinträchtigte Spitzenathlet_innen. Außerdem werden bedeutsame Rahmenbedingungen zur effektiven Durchführung von PST untersucht. Im Hauptergebnis ist festzuhalten, dass psychometrisch geprüfte standardisierte Fragebögen bei hörbeeinträchtigten Athlet_innen nur eingeschränkt eingesetzt werden können. Darüber hinaus sind
auch beim Trainingsprozess besondere Rahmenbedingungen zu beachten.
Objectives
Germany has one of the highest numbers of coronary angiography worldwide. Nevertheless, we find a great variation between German regions for both, diagnostic coronary angiographies and percutaneous coronary interventions (PCI). We assume that this variation is not only due to variation in morbidity but also reflects factors such as guideline adherence, physician-patient communication and access to care.
In this mixed method project, we aim to first describe the variation of coronary angiographies and PCIs in different German regions. Secondly, we explore current practices and motives for (non-)adherences to guidelines in the diagnostic process of patients with suspected CHD. Based on these results, we consequently plan to develop a complex intervention (treatment pathway) to improve guideline adherence and thus appropriateness of coronary angiography.
Method
The projects will be organized according to the recommendation of the Medical Research Council for the development and evaluation of complex interventions. The first study will use descriptive methods based on routine data of three German Health Care Insurances and registry data to describe status quo and associated factors of coronary angiography. The second study will use qualitative methods to understand barriers and facilitators of guideline adherence and medical decision making. Furthermore, we will discuss variations in care and thereby identify implementation targets for the planned treatment pathway. Based on this information, we will develop local treatment pathways in four selected regions. Relevant peers will develop the local pathway in group discussions. Using this bottom-up approach, we directly address implementation challenges.