TY - JOUR A1 - Zetzl, Teresa A1 - Schuler, Michael A1 - Renner, Agnes A1 - Jentschke, Elisabeth A1 - van Oorschot, Birgitt T1 - Yoga intervention and reminder e-mails for reducing cancer-related fatigue - a study protocol of a randomized controlled trial JF - BMC Psychology N2 - Background Almost 90% of cancer patients suffer from symptoms of fatigue during treatment. Supporting treatments are increasingly used to alleviate the burden of fatigue. This study examines the short-term and long-term effects of yoga on fatigue and the effect of weekly reminder e-mails on exercise frequency and fatigue symptoms. Methods The aim of the first part of the study will evaluate the effectiveness of yoga for cancer patients with mixed diagnoses reporting fatigue. We will randomly allocate 128 patients to an intervention group (N = 64) receiving yoga and a wait-list control group (N = 64) receiving yoga 9 weeks later. The yoga therapy will be performed in weekly sessions of 60 min each for 8 weeks. The primary outcome will be self-reported fatigue symptoms. In the second part of the study, the effectiveness of reminder e-mails with regard to the exercise frequency and self-reported fatigue symptoms will be evaluated. A randomized allocated group of the participants (“email”) receives weekly reminder e-mails, the other group does not. Data will be assessed using questionnaires the beginning and after yoga therapy as well as after 6  months. Discussion Support of patients suffering from fatigue is an important goal in cancer patients care. If yoga therapy will reduce fatigue, this type of therapy may be introduced into routine practice. If the reminder e-mails prove to be helpful, new offers for patients may also develop from this. KW - Cancer KW - Fatigue KW - Yoga KW - Reminder e-mails KW - Supportive therapy Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-202268 VL - 7 ER - TY - JOUR A1 - Yurdadogan, Tino A1 - Malsch, Carolin A1 - Kotseva, Kornelia A1 - Wood, David A1 - Leyh, Rainer A1 - Ertl, Georg A1 - Karmann, Wolfgang A1 - Müller-Scholden, Lara A1 - Morbach, Caroline A1 - Breuning, Margret A1 - Wagner, Martin A1 - Gelbrich, Götz A1 - Bots, Michiel L. A1 - Heuschmann, Peter U. A1 - Störk, Stefan T1 - Functional versus morphological assessment of vascular age in patients with coronary heart disease JF - Scientific Reports N2 - Communicating cardiovascular risk based on individual vascular age (VA) is a well acknowledged concept in patient education and disease prevention. VA may be derived functionally, e.g. by measurement of pulse wave velocity (PWV), or morphologically, e.g. by assessment of carotid intima-media thickness (cIMT). The purpose of this study was to investigate whether both approaches produce similar results. Within the context of the German subset of the EUROASPIRE IV survey, 501 patients with coronary heart disease underwent (a) oscillometric PWV measurement at the aortic, carotid-femoral and brachial-ankle site (PWVao, PWVcf, PWVba) and derivation of the aortic augmentation index (AIao); (b) bilateral cIMT assessment by high-resolution ultrasound at three sites (common, bulb, internal). Respective VA was calculated using published equations. According to VA derived from PWV, most patients exhibited values below chronological age indicating a counterintuitive healthier-than-anticipated vascular status: for VA(PWVao) in 68% of patients; for VA\(_{AIao}\) in 52% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VA\(_{total-cIMT}\) accelerated vascular aging in 75% of patients. To strengthen the concept of VA, further efforts are needed to better standardise the current approaches to estimate VA and, thereby, to improve comparability and clinical utility. KW - arterial stiffening KW - atherosclerosis KW - calcification KW - carotid artery disease Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-265810 VL - 11 IS - 1 ER - TY - THES A1 - Yurdadogan, Tino T1 - Endorganschaden und Gefäßalter bei Patienten mit koronarer Herzkrankheit T1 - End organ damage and vascular age in patients with coronary artery disease N2 - Die nicht-invasive Gefäßdiagnostik stellt einen wichtigen Pfeiler in der Prävention von Herz-Kreislauferkrankungen dar. Während lange Zeit die sonographische Messung der cIMT, als morphologisches Korrelat der Gefäßalterung, als Goldstandard galt, ist in den letzten Jahren in Gestalt der Pulswellenanalyse/PWV-Messung eine Technik weiterentwickelt worden, die, als funktionelles Korrelat der Gefäßalterung, aufgrund der leichteren Durchführbarkeit und geringerer Untersucherabhängigkeit und Kosten vielversprechend ist. So erlaubt die Messung der Pulswelle mittels gewöhnlicher Blutdruckmanschetten, genau wie die cIMT, die Berechnung des individuellen Gefäßalters und die Diagnostik für das Vorliegen eines Endorganschadens der Blutgefäße. Um die Messergebnisse der beiden Untersuchungen miteinander zu vergleichen, wurden beide in der EUROASPIRE-IV Studie an Patienten mit koronarer Herzkrankheit durchgeführt. Die Auswertung der Messergebnisse der mit dem Vascular Explorer durchgeführten Pulswellenanalyse/PWV-Messung ergab überraschenderweise, dass die Mehrheit der herzkranken Patienten weder eine vaskuläre Voralterung noch einen Endorganschaden der Blutgefäße aufweisen. Im Falle der cIMT-Messung war Gegenteiliges der Fall, was trotz der medikamentösen Therapie der Patienten so zu erwarten war. Weiterhin zeigte sich lediglich eine geringe Korrelation zwischen den Messergebnissen beider Untersuchungen. Die Determinanten der einzelnen Messwerte aus cIMT und Pulswellenanalyse/PWV-Messung waren deckungsgleich mit den in der Literatur beschriebenen Faktoren, wenn auch viele der sonst signifikanten Regressoren das Signifikanzniveau in unserer Auswertung nicht unterschritten. Eine Limitation der funktionellen Gefäßdiagnostik liegt derzeit darin, dass die Messergebnisse stark von dem verwendeten Messgerät abhängen. Es liegen noch zu wenig Vergleichsstudien vor, um die Messergebnisse, speziell von neueren Geräten wie dem Vascular Explorer, auf andere zu übertragen. Bei der Berechnung des Gefäßalters sollten daher optimalerweise gerätespezifische Normwerte vorliegen, was beim Vascular Explorer nicht der Fall ist. Gleiches gilt für die Verwendung des PWVcf-Grenzwerts für die Diagnose eines Endorganschadens der Blutgefäße. Analog hat auch die Messung der cIMT gewisse Einschränkungen. So wäre eine weitere Standardisierung der Messorte (A. carotis communis vs Bulbus vs A. carotis interna), zwischen denen sich die durchschnittliche cIMT erheblich unterscheidet, sowie der Messparameter (Minimal- vs Maximal- vs Mittelwert) wünschenswert. Die universelle Anwendung eines cIMT-Grenzwerts zur Diagnose eines Endorganschadens der Blutgefäße ist daher kritisch zu sehen. Dies zeigt sich auch darin, dass in den neuesten Leitlinien der bislang geltende Grenzwert angezweifelt und kein aktuell gültiger Grenzwert mehr genannt wird. Wir interpretieren unsere Ergebnisse dahingehend, dass unsere Messung der cIMT die zu erwartende pathologische Gefäßalterung bei Patienten mit koronarer Herzkrankheit besser widerspiegelt als die Messung der Pulswelle mit dem Vascular Explorer. Welche der beiden Untersuchungen hinsichtlich der prognostischen Wertigkeit überlegen ist, muss im Rahmen von Längsschnittstudien geklärt werden. N2 - Non-invasive vascular diagnostics play an important role in the prevention of cardiovascular diseases. For a long time, sonographic measurement of the cIMT was considered the gold standard. Yet, by continually developing the PWA/PWV measurement, a promising technique is available, that is easy to handle and has better inter-examiner reproducibility at lower costs. Just like the cIMT examination, recording and analysing the pulse wave via blood pressure cuffs allows the determination of the individual vascular age and to diagnose end organ damage of the arteries. In order to compare the results of both examinations, they were performed during the EUROASPIRE IV-study in patients with coronary artery disease. Despite being under medication, we expected to find early vascular aging in most patients. Surprisingly, according to the results of the PWA/PWV measurement with the Vascular Explorer device, most of the study population neither showed early vascular aging nor met the criteria for end organ damage of the arteries. cIMT measurements delivered the opposite results. Moreover, we found only poor correlation between the measured values of both examinations. Regression analysis yielded determinants of cIMT and PWA/PWV measurement, which were largely congruent with those described in literature. The most apparent weakness of evaluating the vascular status by means of PWA/PWV measurement lies in the poor inter-device comparability. Due to a lack of comparative studies with large sample sizes, measured values of different devices are currently not transferable. Nonetheless, reference values used for vascular age determination with the Vascular Explorer are available in a study using a different device. Furthermore, the PWV threshold for diagnosing end organ damage is applied regardless of the technique/device used for measurement, although an adjustment is urgently needed. Similarly, the cIMT measurement has certain limitations as efforts can still be made to better standardise examination protocols (e.g. sites of measurement (Common Carotid Artery vs Bulb vs Internal Carotid artery), obtained values (minimum vs maximum vs mean)). The formerly valid cIMT threshold is currently being called into question by the latest guidelines, as there is evidence of its underestimation. Ultimately, cIMT measurement better reflects the expected early vascular aging in patients with coronary artery disease than PWA/PWV measurement with the Vascular Explorer. However, longitudinal studies are necessary to further evaluate the prognostic value of both examinations. KW - Arteriosklerose KW - Pulswelle KW - Koronare Herzkrankheit KW - Endorganschaden KW - Gefäßalter KW - Carotis Intima Media Dicke Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-218469 ER - TY - JOUR A1 - Winter, Michael A1 - Pryss, Rüdiger A1 - Probst, Thomas A1 - Reichert, Manfred T1 - Towards the applicability of measuring the electrodermal activity in the context of process model comprehension: feasibility study JF - Sensors N2 - Process model comprehension is essential in order to understand the five Ws (i.e., who, what, where, when, and why) pertaining to the processes of organizations. However, research in this context showed that a proper comprehension of process models often poses a challenge in practice. For this reason, a vast body of research exists studying the factors having an influence on process model comprehension. In order to point research towards a neuro-centric perspective in this context, the paper at hand evaluates the appropriateness of measuring the electrodermal activity (EDA) during the comprehension of process models. Therefore, a preliminary test run and a feasibility study were conducted relying on an EDA and physical activity sensor to record the EDA during process model comprehension. The insights obtained from the feasibility study demonstrated that process model comprehension leads to an increased activity in the EDA. Furthermore, EDA-related results indicated significantly that participants were confronted with a higher cognitive load during the comprehension of complex process models. In addition, the experiences and limitations we learned in measuring the EDA during the comprehension of process models are discussed in this paper. In conclusion, the feasibility study demonstrated that the measurement of the EDA could be an appropriate method to obtain new insights into process model comprehension. KW - process model KW - process model comprehension KW - electrodermal activity KW - sensor Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-211276 SN - 1424-8220 VL - 20 IS - 16 ER - TY - JOUR A1 - Winter, Michael A1 - Pryss, Rüdiger A1 - Probst, Thomas A1 - Reichert, Manfred T1 - Applying Eye Movement Modeling Examples to guide novices' attention in the comprehension of process models JF - Brain Sciences N2 - Process models are crucial artifacts in many domains, and hence, their proper comprehension is of importance. Process models mediate a plethora of aspects that are needed to be comprehended correctly. Novices especially face difficulties in the comprehension of process models, since the correct comprehension of such models requires process modeling expertise and visual observation capabilities to interpret these models correctly. Research from other domains demonstrated that the visual observation capabilities of experts can be conveyed to novices. In order to evaluate the latter in the context of process model comprehension, this paper presents the results from ongoing research, in which gaze data from experts are used as Eye Movement Modeling Examples (EMMEs) to convey visual observation capabilities to novices. Compared to prior results, the application of EMMEs improves process model comprehension significantly for novices. Novices achieved in some cases similar performances in process model comprehension to experts. The study's insights highlight the positive effect of EMMEs on fostering the comprehension of process models. KW - Business Process Models KW - Process Model Comprehension KW - Eye Movement Modeling Examples KW - eye tracking KW - human-centered design KW - cognition Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222966 SN - 2076-3425 VL - 11 IS - 1 ER - TY - JOUR A1 - Willeke, Kristina A1 - Janson, Patrick A1 - Zink, Katharina A1 - Stupp, Carolin A1 - Kittel-Schneider, Sarah A1 - Berghöfer, Anne A1 - Ewert, Thomas A1 - King, Ryan A1 - Heuschmann, Peter U. A1 - Zapf, Andreas A1 - Wildner, Manfred A1 - Keil, Thomas T1 - Occurrence of mental illness and mental health risks among the self-employed: a systematic review JF - International Journal of Environmental Research and Public Health N2 - We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed. KW - incidence KW - mental disorders KW - mental health KW - mental illness KW - prevalence KW - self-employed KW - small business KW - systematic review Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-245085 SN - 1660-4601 VL - 18 IS - 16 ER - TY - JOUR A1 - Wiedmann, Silke A1 - Heuschmann, Peter U. A1 - Hillmann, Steffi A1 - Busse, Otto A1 - Wiethoelter, Horst A1 - Walter, Georg M. A1 - Seidel, Guenter A1 - Misselwitz, Bjoern A1 - Janssen, Alfred A1 - Berger, Klaus A1 - Burmeister, Christoph A1 - Matthias, Christine A1 - Kolominsky-Rabas, Peter A1 - Hermanek, Peter T1 - The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients JF - Deutsches Ärzteblatt International N2 - Background: Stroke patients should be cared for in accordance with evidence-based guidelines. The extent of implementation of guidelines for the acute care of stroke patients in Germany has been unclear to date. Methods: The regional quality assurance projects that cooperate in the framework of the German Stroke Registers Study Group (Arbeitsgemeinschaft Deutscher Schlaganfall-Register, ADSR) collected data on the care of stroke patients in 627 hospitals in 2012. The quality of the acute hospital care of patients with stroke or transient ischemic attack (TIA) was assessed on the basis of 15 standardized, evidence-based quality indicators and compared across the nine participating regional quality assurance projects. Results: Data were obtained on more than 260 000 patients nationwide. Intravenous thrombolysis was performed in 59.7% of eligible ischemic stroke patients patients (range among participating projects, 49.7-63.6%). Dysphagia screening was documented in 86.2% (range, 74.8-93.1%). For the following indicators, the defined targets were not reached for all of Germany: antiaggregation within 48 hours, 93.4% (range, 86.6-96.4%); anticoagulation for atrial fibrillation, 77.6% (range, 72.4-80.1%); standardized dysphagia screening, 86.2% (range, 74.8-93.1%); oral and written information of the patients or their relatives, 86.1% (range, 75.4-91.5%). The rate of patients examined or treated by a speech therapist was in the target range. Conclusion: The defined targets were reached for most of the quality indicators. Some indicators, however, varied widely across regional quality assurance projects. This implies that the standardization of care for stroke patients in Germany has not yet been fully achieved. KW - Hesse KW - study-group ADSR KW - ischemic-stroke KW - Germany KW - implementation KW - rehabilitation Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-114747 SN - 1866-0452 VL - 111 IS - 45 ER - TY - JOUR A1 - Wiedmann, Silke A1 - Heuschmann, Peter U. A1 - Hermanek, Peter T1 - In reply: The quality of acute stroke treatment-an analysis of evidence-based indicators in 260 000 patients JF - Deutsches Aerzteblatt International N2 - No abstract available. KW - acute stroke KW - treatment Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-148666 VL - 112 ER - TY - JOUR A1 - Wetzel, Britta A1 - Pryss, Rüdiger A1 - Baumeister, Harald A1 - Edler, Johanna-Sophie A1 - Gonçalves, Ana Sofia Oliveira A1 - Cohrdes, Caroline T1 - “How come you don’t call me?” Smartphone communication app usage as an indicator of loneliness and social well-being across the adult lifespan during the COVID-19 pandemic JF - International Journal of Environmental Research and Public Health N2 - Loneliness and lack of social well-being are associated with adverse health outcomes and have increased during the COVID-19 pandemic. Smartphone communication data have been suggested to help monitor loneliness, but this requires further evidence. We investigated the informative value of smartphone communication app data for predicting subjective loneliness and social well-being in a sample of 364 participants ranging from 18 to 78 years of age (52.2% female; mean age = 42.54, SD = 13.22) derived from the CORONA HEALTH APP study from July to December 2020 in Germany. The participants experienced relatively high levels of loneliness and low social well-being during the time period characterized by the COVID-19 pandemic. Apart from positive associations with phone call use times, smartphone communication app use was associated with social well-being and loneliness only when considering the age of participants. Younger participants with higher use times tended to report less social well-being and higher loneliness, while the opposite association was found for older adults. Thus, the informative value of smartphone communication use time was rather small and became evident only in consideration of age. The results highlight the need for further investigations and the need to address several limitations in order to draw conclusions at the population level. KW - loneliness KW - social well-being KW - passive data KW - app KW - smartphone communication KW - COVID-19 KW - social media use KW - age differences KW - public mental health KW - mental health monitoring Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-241033 SN - 1660-4601 VL - 18 IS - 12 ER - TY - THES A1 - Wahl, Valerie Elisabeth T1 - Empfehlungen zu Lebensstilveränderungen und deren Umsetzung nach einem koronaren Ereignis - Ergebnisse der EUROASPIRE IV-Studie im Raum Würzburg T1 - Recommendations on lifestyle changes and their implementation after a coronary event – Results from the EUROASPIRE IV survey in the Würzburg region N2 - Die koronare Herzkrankheit ist weltweit die häufigste Todesursache und belastet die Gesellschaft durch Therapien und Arbeitsausfälle mit hohen Kosten. Die Europäischen Gesellschaft für Kardiologie empfiehlt in den Leitlinien zur Sekundärprävention der koronaren Herzkrankheit verschiedene Lebensstiländerungen. In der vorliegenden Arbeit wurde untersucht, wie häufig diese Empfehlungen tatsächlich gegeben werden, ob diese von den Patienten umgesetzt werden und welche Faktoren den Erhalt der Empfehlung bzw. die Umsetzung beeinflussen. Hierzu wurden 536 Probanden mit bekannter KHK aus dem Raum Würzburg im Rahmen der multizentrischen Querschnittsstudie EUROASPIRE IV befragt und untersucht. Es konnte gezeigt werden, dass die Empfehlungen insgesamt viel zu selten gegeben werden. Als positiver Einflussfaktor für den Erhalt einer Empfehlung konnte die Teilnahme an einem Rehabilitationsprogramm identifiziert werden. Die Wahrscheinlichkeit, die Empfehlungen zu erhalten, sank zudem mit zunehmendem Alter bei Erstdiagnose der KHK. Diese Erkenntnisse können in Zukunft dabei helfen, die Aufklärung über die Risikofaktoren insgesamt und besonders bei älteren Menschen zu intensivieren. Sie untermauern zudem die große Bedeutung eines Rehabilitationsprogrammes bei der Informationsvermittlung. Auch die Umsetzung der empfohlenen Lebensstilveränderungen erfolgte nicht in zufriedenstellender Häufigkeit. Für die Beendigung des Rauchens konnte die Teilnahme an einem Rehabilitationsprogramm als größter Einflussfaktor ermittelt werden. Die Wahrscheinlichkeit, dass die verschiedenen Maßnahmen zu Lebensstilveränderungen umgesetzt werden, war beim weiblichen Geschlecht deutlich höher als beim männlichen. Die Umsetzung wurde zudem dadurch beeinflusst, ob der Patient vorher die entsprechende Empfehlung erhalten hatte. Die Daten zeigen somit auch bei der Umsetzung der Maßnahmen die Bedeutung von Rehabilitationsprogrammen, besonders für Raucher, und verdeutlichen, dass vor allem bei Männern weitere Anreize geschaffen werden müssen, damit diese die Empfehlungen zur Lebensstiländerung auch umsetzen. Dass viel mehr Probanden die Maßnahmen umgesetzt haben, wenn sie vorher die entsprechende Empfehlung erhalten haben, unterstreicht die außerordentliche Wichtigkeit der umfassenden Aufklärung des Patienten über die existentiellen Chancen eines Lebensstilwandels. N2 - Coronary heart disease (CHD) is the leading cause of death worldwide and is a burden for the society with high costs through therapies and absenteeisms. The European Society of Cardiology recommends various lifestyle changes in their guidelines on cardiovascular disease prevention. The present work investigates the frequency of recommendations given by physicians, the implementation by the patients and the factors affecting both the receipt and the implementation of these recommendations. Therefore, 536 participants with a known CHD in the Würzburg region were interviewed and examined within the German subset of the multicenter cross-sectional EUROASPIRE IV survey. The results showed that recommendations are given infrequently. The attendance of a rehabilitation program was determined as a positive factor for the receipt of a recommendation. With increasing age at initial diagnosis of CHD, the receipt of a recommendation was less likely. These findings may help intensify the education about the risk factors overall and particularly for older people. Furthermore, the findings corroborate the importance of a rehabilitation program to impart information about lifestyle changes. The recommended lifestyle changes were also implemented infrequently. As the primary factor to stop smoking, the attendance of a rehabilitation program was identified. The implementation of various lifestyle changes was more likely in female than in male patients. Moreover, the receipt of a recommendation affected the implementation. The importance of rehabilitation programs for the implementation of lifestyle changes is shown particularly for current smokers. Male patients must be further incentivised to implement the recommended lifestyle changes. The exceptional importance of comprehensive education about the existential opportunities of lifestyle changes is underlined by the fact that significantly more patients implemented lifestyle changes after a given recommendation. KW - Koronare Herzkrankheit KW - Sekundärprävention KW - Lebensstilveränderung Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200203 ER -