@phdthesis{Alkhargi2020, author = {Alkhargi, Manuel}, title = {Cancer And Living Meaningfully: eine qualitative Studie zur Treatment Integrity der CALM-Therapie im Vergleich zu einer Kontrollbedingung}, doi = {10.25972/OPUS-19939}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-199390}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Hintergrund: Circa ein Drittel der Patientinnen und Patienten mit fortgeschrittenen Krebserkrankungen ist von psychischen Komorbidit{\"a}ten betroffen und circa die H{\"a}lfte weist eine psychische Belastung im klinisch signifikanten Bereich auf. Zur psychotherapeutischen Behandlung dieser Patientengruppe stehen unterschiedliche psychotherapeutische Interventionen zur Verf{\"u}gung. Die CALM-Therapie, eine manualisierte Kurzintervention im Einzelsetting, ist eine dieser Interventionen. Hier bilden vier Module, welche auf den wichtigsten Anliegen und Belastungsfaktoren von Patientinnen und Patienten mit fortgeschrittenen Krebserkrankungen basieren, den inhaltlichen Rahmen. Ziel: Die Treatment Integrity beschreibt das Maß, inwieweit eine psychotherapeutische Intervention wie vorgesehen umgesetzt wurde. F{\"u}r eine fundierte Interpretation psychotherapeutischer Interventionseffekte sind Kenntnisse {\"u}ber die Treatment Integrity entscheidend. Die vorliegende Arbeit untersuchte Teilaspekte der Treatment Integrity durchgef{\"u}hrter CALM-Therapien im Vergleich zu durchgef{\"u}hrten konventionellen psychoonkologischen Therapien, um einen Beitrag zu einer fundierten Interpretation von Interventionseffekten der CALM-Therapie zu leisten. Methoden: Transkriptionen von zwei CALM-Therapien und zwei Therapien einer konventionellen psychoonkologischen Intervention wurden anhand einer qualitativen Inhaltsanalyse nach P. Mayring untersucht. Im Zentrum stand hierbei ein selbst entwickeltes Kategoriensystem zur Analyse des gesamten Textmaterials. Zus{\"a}tzlich wurden Auff{\"a}lligkeiten bez{\"u}glich Ansprachen von Themenbereichen der CALM-Module unsystematisch beobachtet. Ergebnisse: Die Inhalte der untersuchten CALM-Therapien bezogen sich durchschnittlich zu 99,54\% und die der konventionellen psychoonkologischen Therapien durchschnittlich zu 98,71\% auf die Themenbereiche der CALM-Module. Die ermittelten Werte f{\"u}r einzelne Therapiesitzungen lagen f{\"u}r CALM-Sitzungen zwischen 98,12\% und 100\% und f{\"u}r Sitzungen der konventionellen psychoonkologischen Therapie zwischen 96,20\% und 100\%. Unsystematisch beobachtete Auff{\"a}lligkeiten zeigten, dass die Themenbereiche der CALM-Module zum Teil sehr spezifisch durch die CALM-Therapeutinnen und -Therapeuten angesprochen und vernetzt wurden. Schlussfolgerung: Unter Ber{\"u}cksichtigung von methodischen Grenzen zeigte sich bez{\"u}glich des Anteils von Themenbereichen der CALM-Module innerhalb der beiden untersuchten Therapiegruppen kein maßgeblicher Unterschied. Zus{\"a}tzlich liefert die vorliegende Arbeit Hinweise f{\"u}r einen spezifischen therapeutischen Umgang mit den Themenbereichen der CALM-Module innerhalb der untersuchten CALM-Therapien. Um ermittelte Interventionseffekte der CALM-Therapie fundiert interpretieren zu k{\"o}nnen, sollten zuk{\"u}nftige Untersuchungen unterschiedliche Umgangsweisen von Therapeutinnen und Therapeuten der beiden Therapiegruppen mit den Themenbereichen der CALM-Module genauer in den Blick nehmen.}, subject = {Psychoonkologie}, language = {de} } @phdthesis{Fleckenstein2020, author = {Fleckenstein, Katrin}, title = {Patienten mit Migrationshintergrund in einem Bezirkskrankenhaus - eine klinische Querschnittsanalyse}, doi = {10.25972/OPUS-21445}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214454}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Deutschland ist im europ{\"a}ischen Vergleich ein Hauptzielland von Migration. Migration kann eine bestimmte psychosoziale Vulnerabilit{\"a}t mit sich bringen. Der Zusammenhang zwischen der psychischen Gesundheit von Patienten mit Migrationshintergrund und den Faktoren, die diese beeinflussen ist sehr komplex und vielseitig. Ziel der vorliegenden Querschnittsanalyse ist es zu einem besseren Verst{\"a}ndnis der Risikofaktoren f{\"u}r die psychiatrischen Erkrankungen von Patienten mit Migrationshintergrund und den Erfolg der station{\"a}ren psychiatrischen Behandlung beizutragen. Daf{\"u}r wurde zum einen die psychische Gesundheit von Migranten und Asylanten, die sich in station{\"a}r psychiatrischer Behandlung in einem Bezirkskrankenhaus befanden, untersucht und mit der psychischen Gesundheit von Nichtmigranten verglichen. Zum anderen wurden Menschen mit Migrationshintergrund, die sich in station{\"a}r psychiatrischer Behandlung befanden, hinsichtlich ihrer Herkunftsl{\"a}nder und ihrer Lebensumst{\"a}nde charakterisiert sowie Daten hinsichtlich ihrer Integration, das Krankheitsempfinden und die Erwartungen an die Therapie erfasst. Außerdem wurde der station{\"a}re Aufenthalt reflektiert.}, subject = {Migrationshintergrund}, language = {de} } @phdthesis{Nentwich2020, author = {Nentwich, Julia Anna}, title = {Pilot- und Modellprojekt: Studie zur Erfassung der k{\"o}rperlichen Aktivit{\"a}t und Lebensqualit{\"a}t bei Jugendlichen zwischen 13 und 18 Jahren mit chronisch nichtbakterieller Osteomyelitis (CNO)}, doi = {10.25972/OPUS-20575}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-205758}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Bei der chronischen nicht-bakteriellen Osteomyelitis (CNO) handelt es sich um eine autoinflammatorische Erkrankung der Knochen bislang unbekannnter {\"A}tiologie. Die Patienten leiden unter anderem durch lokale Entz{\"u}ndungen an Knochenschmerzen und hieraus resuliterender funktioneller Einschr{\"a}nkung. Das Ziel dieser Studie war es, die k{\"o}rperliche Aktivit{\"a}t, Fitness und HRQoL von Jugendlichen mit best{\"a}tigter CNO-Diagnose im Vergleich zu gesunden Kontrollen zu untersuchen. Daf{\"u}r wurden 15 Patienten mit CNO und 15 alters- und gesschlechts-gematchte gesunde Jugendliche zwischen 13 und 18 Jahren in die Studie eingeschlossen. Sie f{\"u}llten hierf{\"u}r Frageb{\"o}gen bez{\"u}glich ihrer Lebensqualit{\"a}t aus, leisteten auf einem Fahrradergometer einen Ausdauertest zur Messung der aeroben Fitness und trugen f{\"u}r sieben Tage zuhause einen Bewegungssensor (Accelerometer), um die k{\"o}rperliche Aktivit{\"a}t im Alltag zu messen. Zum Untersuchungszeitpunkt waren ein Drittel der Patienten in kompletter Remission, ein weiteres Drittel nur in klinischer und ein Patient nur in radiologischer Remission. Fast die H{\"a}lfte (47\%) erhielt zu diesem Zeitpunkt keine medikament{\"o}se Therapie mehr. In den objektiven Untersuchungsmethoden (Spiroergometrie und Accelerometrie) konnten keine relevanten Einschr{\"a}nkungen in der k{\"o}rperlichen Fitness und dem durchschnittlichen Aktivit{\"a}tsniveau festgestellt werden. Dennoch nahmen die CNO-Patienten deutlich weniger am Sportunterricht teil und in den Frageb{\"o}gen erzielten sie deutlich schlechtere Werte, die auf eine reduzierte Lebensqualit{\"a}t schließen lassen. Vor allem klagten sie deutlich h{\"a}ufiger {\"u}ber Schmerz und gaben deutlich mehr Sorgen an. Obwohl also bei den meisten Jugendlichen ein sehr positiver Krankheitsverlauf festzustellen war, der keinerlei Unterschiede in den objektiven Messmethoden zu den gesunden Jugendlichen mehr zeigte, enth{\"u}llten die Frageb{\"o}gen deutliche Defizite. Zur besseren Messung der HRQoL und der Validierung der Frageb{\"o}gen f{\"u}r CNO im Vergleich zu objektiven Untersuchungsmethoden werden weitere Studien ben{\"o}tigt.}, subject = {chronisch nicht-bakterielle Osteomyelitis}, language = {de} } @article{HegerlWittenburgArensmanetal.2009, author = {Hegerl, Ulrich and Wittenburg, Lisa and Arensman, Ella and Van Audenhove, Chantal and Coyne, James C. and McDaid, David and van der Feltz-Cornelis, Christina M. and Gusm{\~a}o, Ricardo and Kopp, M{\´a}ria and Maxwell, Margaret and Meise, Ullrich and Roskar, Saska and Sarchiapone, Marco and Schmidtke, Armin and V{\"a}rnik, Airi and Bramesfeld, Anke}, title = {Optimizing Suicide Prevention Programs and Their Implementation in Europe (OSPI Europe): an evidence-based multi-level approach}, series = {BMC Public Health}, volume = {9}, journal = {BMC Public Health}, number = {428}, doi = {10.1186/1471-2458-9-428}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154695}, year = {2009}, abstract = {Background Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. Method The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. Discussion This multi-centre research seeks to overcome major challenges of field research in suicide prevention. It pools data from four European regions, considerably increasing the study sample, which will be close to one million. In addition, the study will gather important information concerning the potential to transfer this multilevel program to other health care systems. The results of this research will provide a basis for developing an evidence-based, efficient concept for suicide prevention for EU-member states.}, language = {en} } @article{BornZinnerDuekingetal.2016, author = {Born, Dennis-Peter and Zinner, Christoph and D{\"u}king, Peter and Sperlich, Billy}, title = {Multi-Directional Sprint Training Improves Change-Of-Direction Speed and Reactive Agility in Young Highly Trained Soccer Players}, series = {Journal of Sports Science and Medicine}, volume = {15}, journal = {Journal of Sports Science and Medicine}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-146866}, pages = {314-319}, year = {2016}, abstract = {The aim of this study was to evaluate the effect of a repeated sprint training with multi-directional change-of-direction (COD) movements (RSmulti) compared to repeated shuttle sprints (RSS) on variables related to COD speed and reactive agility. Nineteen highly-trained male U15 soccer players were assigned into two groups performing either RSmulti or RSS. For both groups, each training session involved 20 repeated 15 s sprints interspersed with 30 s recovery. With RSmulti the COD movements were randomized and performed in response to a visual stimulus, while the RSS involved predefined 180° COD movements. Before and following the six training sessions, performance in the Illinois agility test (IAT), COD speed in response to a visual stimulus, 20 m linear sprint time and vertical jumping height were assessed. Both groups improved their performance in the IAT (p < 0.01, ES = 1.13; p = 0.01, ES = 0.55). The COD speed in response to a visual stimulus improved with the RSmulti (p < 0.01, ES = 1.03), but not the RSS (p = 0.46, ES = 0.28). No differences were found for 20 m sprint time (P=0.73, ES = 0.07; p = 0.14, ES = 0.28) or vertical jumping height (p = 0.46, ES = 0.11; p = 0.29, ES = 0.12) for the RSmulti and RSS, respectively. In conclusion, performance in the IAT improved with the RSmulti as well as RSS. With the RSmulti however, the COD movements are performed in response to a visual stimulus, which may result in specific adaptations that improve COD speed and reactive agility in young highly trained soccer players.}, language = {en} } @article{ZinnerSperlichWahletal.2015, author = {Zinner, Christoph and Sperlich, Billy and Wahl, Patrick and Mester, Joachim}, title = {Classification of selected cardiopulmonary variables of elite athletes of different age, gender, and disciplines during incremental exercise testing}, series = {SpringerPlus}, volume = {4}, journal = {SpringerPlus}, number = {544}, doi = {10.1186/s40064-015-1341-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126275}, year = {2015}, abstract = {Incremental exercise testing is frequently used as a tool for evaluating determinants of endurance performance. The available reference values for the peak oxygen uptake \((VO_{2peak})\), \% of \(VO_{2peak}\) , running speed at the lactate threshold \((v_{LT})\), running economy (RE), and maximal running speed \((v_{peak})\) for different age, gender, and disciplines are not sufficient for the elite athletic population. The key variables of 491 young athletes (age range 12-21 years; 250 males, 241 females) assessed during a running step test protocol \((2.4 m s^{-1} ; increase 0.4 m s^{-1} 5 min^{-1})\) were analysed in five subgroups, which were related to combat-, team-, endurance-, sprint- and power-, and racquet-related disciplines. Compared with female athletes, male athletes achieved a higher \(v_{peak}\) (P = 0.004). The body mass, lean body mass, height, abs. \(VO_{2peak} (ml min^{-1})\), rel. \(VO_{2peak} (ml kg^{-1} min^{-1})\), rel. \(VO_{2peak} (ml min^{-1} kg^{-0.75})\), and RE were higher in the male participants compared with the females (P < 0.01). The \% of \(VO_2\) at \(v_{LT}\) was lower in the males compared with the females (P < 0.01). No differences between gender were detected for the \(v_{LT}\) (P = 0.17) and \% of \(VO_2\) at \(v_{LT}\) (P = 0.42). This study is one of the first to provide a broad spectrum of data to classify nearly 500 elite athletes aged 12-21 years of both gender and different disciplines.}, language = {en} } @article{ZinnerHauserBornetal.2015, author = {Zinner, Christoph and Hauser, Anna and Born, Dennis-Peter and Wehrlin, Jon P. and Holmberg, Hans-Christer and Sperlich, Billy}, title = {Influence of Hypoxic Interval Training and Hyperoxic Recovery on Muscle Activation and Oxygenation in Connection with Double-Poling Exercise}, series = {PLoS One}, volume = {10}, journal = {PLoS One}, number = {10}, doi = {10.1371/journal.pone.0140616}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126299}, pages = {e0140616}, year = {2015}, abstract = {Here, we evaluated the influence of breathing oxygen at different partial pressures during recovery from exercise on performance at sea-level and a simulated altitude of 1800 m, as reflected in activation of different upper body muscles, and oxygenation of the m. triceps brachii. Ten well-trained, male endurance athletes (25.3±4.1 yrs; 179.2±4.5 cm; 74.2±3.4 kg) performed four test trials, each involving three 3-min sessions on a double-poling ergometer with 3-min intervals of recovery. One trial was conducted entirely under normoxic (No) and another under hypoxic conditions \((Ho; F_iO_2 = 0.165)\). In the third and fourth trials, the exercise was performed in normoxia and hypoxia, respectively, with hyperoxic recovery \((HOX; F_iO_2 = 1.00)\) in both cases. Arterial hemoglobin saturation was higher under the two HOX conditions than without HOX (p<0.05). Integrated muscle electrical activity was not influenced by the oxygen content (best d = 0.51). Furthermore, the only difference in tissue saturation index measured via near-infrared spectroscopy observed was between the recovery periods during the NoNo and HoHOX interventions (P<0.05, d = 0.93). In the case of HoHo the athletes' \(P_{mean}\) declined from the first to the third interval (P < 0.05), whereas Pmean was unaltered under the HoHOX, NoHOX and NoNo conditions. We conclude that the less pronounced decline in \(P_{mean}\) during 3 x 3-min double-poling sprints in normoxia and hypoxia with hyperoxic recovery is not related to changes in muscle activity or oxygenation. Moreover, we conclude that hyperoxia \((F_iO_2 = 1.00)\) used in conjunction with hypoxic or normoxic work intervals may serve as an effective aid when inhaled during the subsequent recovery intervals.}, language = {en} } @article{HeldMittnachtKolbetal.2014, author = {Held, Matthias and Mittnacht, Maria and Kolb, Martin and Karl, Sabine and Jany, Berthold}, title = {Pulmonary and Cardiac Function in Asymptomatic Obese Subjects and Changes following a Structured Weight Reduction Program: A Prospective Observational Study}, series = {PLOS ONE}, volume = {9}, journal = {PLOS ONE}, number = {9}, doi = {10.1371/journal.pone.0107480}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119239}, pages = {e107480}, year = {2014}, abstract = {Background The prevalence of obesity is rising. Obesity can lead to cardiovascular and ventilatory complications through multiple mechanisms. Cardiac and pulmonary function in asymptomatic subjects and the effect of structured dietary programs on cardiac and pulmonary function is unclear. Objective To determine lung and cardiac function in asymptomatic obese adults and to evaluate whether weight loss positively affects functional parameters. Methods We prospectively evaluated bodyplethysmographic and echocardiographic data in asymptomatic subjects undergoing a structured one-year weight reduction program. Results 74 subjects (32 male, 42 female; mean age 42±12 years) with an average BMI 42.5±7.9, body weight 123.7±24.9 kg were enrolled. Body weight correlated negatively with vital capacity (R = -0.42, p<0.001), FEV1 (R = -0.497, p<0.001) and positively with P 0.1 (R = 0.32, p = 0.02) and myocardial mass (R = 0.419, p = 0.002). After 4 months the study subjects had significantly reduced their body weight (-26.0±11.8 kg) and BMI (-8.9±3.8) associated with a significant improvement of lung function (absolute changes: vital capacity +5.5±7.5\% pred., p<0.001; FEV1+9.8±8.3\% pred., p<0.001, ITGV+16.4±16.0\% pred., p<0.001, SR tot -17.4±41.5\% pred., p<0.01). Moreover, P0.1/Pimax decreased to 47.7\% (p<0.01) indicating a decreased respiratory load. The change of FEV1 correlated significantly with the change of body weight (R = -0.31, p = 0.03). Echocardiography demonstrated reduced myocardial wall thickness (-0.08±0.2 cm, p = 0.02) and improved left ventricular myocardial performance index (-0.16±0.35, p = 0.02). Mitral annular plane systolic excursion (+0.14, p = 0.03) and pulmonary outflow acceleration time (AT +26.65±41.3 ms, p = 0.001) increased. Conclusion Even in asymptomatic individuals obesity is associated with abnormalities in pulmonary and cardiac function and increased myocardial mass. All the abnormalities can be reversed by a weight reduction program.}, language = {en} } @article{WallmannSperlichFroboeseSchantz2014, author = {Wallmann-Sperlich, Birgit and Froboese, Ingo and Schantz, Peter}, title = {Physical Activity and the Perceived Neighbourhood Environment - Looking at the Association the Other Way Around}, series = {International Journal of Environmental Research and Public Health}, volume = {11}, journal = {International Journal of Environmental Research and Public Health}, number = {8}, issn = {1660-4601}, doi = {10.3390/ijerph110808093}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119441}, pages = {8093-8111}, year = {2014}, abstract = {The association between physical activity (PA) and variables of the perceived environment mainly originate from cross-sectional studies that introduced the idea that the environment influences the PA level of residents. However, the direction of cause and effect has not been solved with finality. The aim of this study was to investigate whether residents' perception of their proximate environment differs depending on their level of PA in transport and recreation. We conducted a cross-sectional survey with residents of six different parts of the city of Cologne, Germany. The sample of 470 adults (52.8\% females; mean age = 35.5 ± 13.8 years) filled in the Global Physical Activity Questionnaire (GPAQ), as well as the European Environmental Questionnaire ALPHA. To distinguish between residents with "low" and "high" PA, we split the samples into two on the basis of the specific median in transport- and recreation-related PA. In the "high" vs. "low" PA group of the overall sample, we noted 4\%-16\% more "PA favourable" environmental perceptions in seven of the 15 environmental variables. Multiple linear regression analyses were performed to investigate associations of socio-demographic correlates and transport- and recreation-related PA on the dependent variables of the environmental perception. In this case, levels of PA were significant predictors for eight of the 15 items concerning environmental perceptions. Thus, the present study introduces the idea that residents with higher levels of transport and recreational PA may perceive their environment in a more "PA-favourable" way than residents with lower levels.}, language = {en} } @article{KristDimeoKeil2013, author = {Krist, Lilian and Dimeo, Fernando and Keil, Thomas}, title = {Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility? A pilot study}, series = {Clinical Interventions in Aging}, volume = {8}, journal = {Clinical Interventions in Aging}, doi = {10.2147/CIA.S42136}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-122176}, pages = {443-448}, year = {2013}, abstract = {Purpose: To determine the effects of progressive resistance training on mobility, muscle strength, and quality of life in nursing-home residents with impaired mobility. Methods: Nursing-home residents aged 77 years and older with impaired mobility were recruited in Berlin, Germany. The eight-week exercise program consisted of progressive resistance training twice a week. Mobility (primary outcome) was assessed with the Elderly Mobility Scale (zero = worst, 20 = best) at baseline and after 8 weeks. Muscle strength (secondary outcome) was determined by the eight-repetition maximum. The Short Form-36 Health Survey was used to assess quality of life. Results: Of the 15 participants (mean age 84 years, range 77-97 years), ten completed the 8-week program. Mobility (Elderly Mobility Scale mean +/- standard deviation pre 14.1 +/- 3.2 and post 17.5 +/- 3.6; P = 0.005) as well as muscle strength of upper and lower limbs improved (from 62\% at chest press up to 108\% at leg extension machine), whereas most quality of life subscales did not show considerable change. Conclusion: Resistance training twice a week over 2 months seemed to considerably improve mobility and muscle strength in persons aged 77-97 years with impaired mobility.}, language = {en} }