Refine
Has Fulltext
- yes (146)
Is part of the Bibliography
- yes (146)
Year of publication
Document Type
- Journal article (141)
- Doctoral Thesis (5)
Language
- English (146) (remove)
Keywords
- ischemic stroke (13)
- stroke (9)
- asthma (8)
- COVID-19 (7)
- secondary prevention (7)
- tinnitus (7)
- prevalence (6)
- Germany (5)
- epidemiology (5)
- mHealth (5)
- mortality (5)
- physical activity (5)
- atrial fibrillation (4)
- coronary heart disease (4)
- ecological momentary assessment (4)
- guideline adherence (4)
- heart failure (4)
- machine learning (4)
- ARIA (3)
- Asthma (3)
- IgE (3)
- birth cohort (3)
- cardiovascular risk factors (3)
- chronic kidney disease (3)
- coronary artery disease (3)
- crowdsensing (3)
- diabetes mellitus (3)
- hypertension (3)
- mental health (3)
- migrants (3)
- quality of life (3)
- rhinitis (3)
- risk (3)
- risk factors (3)
- systematic review (3)
- EUROASPIRE (2)
- Fabry disease (2)
- Fabry-associated pain (2)
- MASK (2)
- Medicine (2)
- SARS-CoV-2 (2)
- Stroke (2)
- age (2)
- biomarker (2)
- biomarkers (2)
- blood pressure (2)
- cancer (2)
- cardiac rehabilitation (2)
- cardiac surgery (2)
- cardiovascular events (2)
- childhood asthma (2)
- chronic heart failure (2)
- cohort studies (2)
- disease (2)
- environmental exposure (2)
- factor XI (2)
- factor XII (2)
- food allergy (2)
- guidelines (2)
- health-related quality of life (2)
- implementation (2)
- incidence (2)
- inpatient rehabilitation (2)
- ischaemic stroke (2)
- left ventricular mass (2)
- magnetic resonance imaging (2)
- management (2)
- maternal exposure (2)
- metaanalysis (2)
- metallic trace elements (2)
- mixed methods (2)
- mobile health (2)
- myocardial infarction (2)
- myocardial work (2)
- outcomes (2)
- predictors (2)
- prenatal exposure (2)
- reliability (2)
- scientific guidelines (2)
- self-help (2)
- thrombolysis (2)
- trial (2)
- troponin (2)
- type 2 diabetes (2)
- unexpressed needs (2)
- urinary tract infections (2)
- 18FDG-PET/CT (1)
- AIRWAYS ICPs (1)
- AKI (1)
- ALAN (1)
- ARDS (acute respiratory distress syndrome) (1)
- Adults (1)
- Akutes Nierenversagen (1)
- Allergic rhinitis (1)
- Apple Watch 7 (1)
- B cells (1)
- BPM (1)
- BPMN (1)
- Barthel-Index (1)
- Business Process Models (1)
- CARAT (1)
- CHRODIS (1)
- COMT (1)
- Cancer (1)
- Cardiac Efficiency (1)
- Cardiovascular risk factors (1)
- Cardiovascular risk prediction (1)
- Carotid intima-media thickness (CIMT) (1)
- Carotid segment (1)
- Carotid ultrasound (1)
- Chronic respiratory diseases (1)
- Chronic rhino‑sinusitis (1)
- Chronische Nierenerkrankung (1)
- Clinical trials (1)
- Clinically silent stroke (1)
- Coronary heart disease (1)
- Covid-19 (1)
- Der p 23 (1)
- ECG-recording (1)
- EIP on AHA (1)
- ELISPOT (1)
- EUROASPIRE survey (1)
- Echocardiography (1)
- Echokardiographie (1)
- Ecological Momentary Assessments (1)
- English version (1)
- Europe (1)
- European Innovation Partnership on Active and Healthy Ageing (1)
- European countries (1)
- Explainable AI (1)
- Explainable Artificial Intelligence (1)
- Eye Movement Modeling Examples (1)
- FDG-PET/CT (1)
- Fabry nephropathy (1)
- Fabry patient (1)
- Fatigue (1)
- Fitbit Sense (1)
- Fruits (1)
- GA\(^2\)LEN (1)
- Garmin Fenix 6 Pro (1)
- German Stroke Registers Study Group (1)
- Glatiramer acetate (1)
- Good Practices (1)
- HFpEF (1)
- HFrEF (1)
- HRQL (1)
- Health care service research (1)
- Heart Failure (1)
- Herzinsuffizienz (1)
- Herzthoraxchirurgie (1)
- Hesse (1)
- HiGHmed (1)
- Hypertension (1)
- ICD-CRT (1)
- ICD-coding of CKD (1)
- IgE sensitazion (1)
- Inflammation (1)
- IoT (1)
- IoT-driven processes (1)
- KDIGO (1)
- Koronare Herzkrankheit (1)
- LV Function (1)
- LV dilatation (1)
- LV mass (1)
- Letalität (1)
- Location-based algorithms (1)
- MACVIA (1)
- MDR (1)
- MS (1)
- Machine Learning (1)
- Maschinelles Lernen (1)
- MeDALL (1)
- Metastatic breast cancer (1)
- Meta‑analysis (1)
- Mobile Crowdsensing (1)
- Mobile Health (1)
- Mobile application engineering (1)
- Mobile augmented reality (1)
- Mobile augmented reality game (1)
- Multimorbidity (1)
- Multiple myeloma (1)
- Myocardial Work (1)
- NAFLD (1)
- NAKO (1)
- NOAC (1)
- NSSI (1)
- Neurodegeneration (1)
- PTSD (1)
- Pain questionnaire (1)
- Patient-centered care (1)
- Patient-centered registry (1)
- Patient’s needs (1)
- Prevalence (1)
- Process Model Comprehension (1)
- Qualitätsindikator (1)
- RCT (1)
- RT-PCR (1)
- Rehabilitation (1)
- Reminder e-mails (1)
- Rezidiv (1)
- Rhinitis (1)
- SARS-CoV- 2 (1)
- SCORE (1)
- STAAB Cohort Study (1)
- Scaling up (1)
- Schlaganfall (1)
- Sekundärprävention (1)
- Serious game (1)
- Social support (1)
- Social work (1)
- Sterblichkeit (1)
- Sunfrail (1)
- Supportive therapy (1)
- Systematic review (1)
- TGFβ1 (1)
- Tabakkonsum (1)
- Tobacco smoking (1)
- Trend (1)
- Turkish (1)
- Vegetables (1)
- Wasted Work (1)
- Withings ScanWatch (1)
- Yoga (1)
- accessibility (1)
- acculturation (1)
- accuracy (1)
- acetylsalicylic acid exacerbated respiratory disease (1)
- activated receptor-1 (1)
- acupressure (1)
- acute ischemic stroke (1)
- acute kidney injury (1)
- acute stroke (1)
- adolescence (1)
- adult (1)
- adult-onset (1)
- adults with congenital heart disease (1)
- age differences (1)
- aggression (1)
- aldosterone (1)
- allergic rhinitis (1)
- allergy (1)
- anemia (1)
- anomaly detection (1)
- antibiotic resistance (1)
- antigen testing (1)
- aortic valve replacement (1)
- apoptosis (1)
- app (1)
- architectural design (1)
- areas (1)
- arterial stiffening (1)
- artificial light at night (1)
- aspirin sensitivity (1)
- aspirin-induced asthma (1)
- asymptomatic screening (1)
- atherosclerosis (1)
- atherothrombosis (1)
- atopic dermatitis (1)
- atopic-dermatitis (1)
- autoimmune (1)
- awareness (1)
- balance (1)
- beta-blockers (1)
- bibliometric analysis (1)
- bioelectronics (1)
- biological rapid deployment aortic valve (1)
- biological rhythm (1)
- birth cohort study (1)
- blood (1)
- blood lipids (1)
- blood sampling (1)
- blood-glucose (1)
- brain edema (1)
- brain endothelium (1)
- breast cancer (1)
- breastfeeding (1)
- bullous pemphigoid (1)
- calcification (1)
- cardiac arrhythmia (1)
- cardiac hypertrophy (1)
- cardiac rehabilitation standards (1)
- cardiopulmonary bypass (1)
- cardiovascular diseases (1)
- care tempis (1)
- carotid artery (1)
- carotid artery disease (1)
- carotid atherosclerosis (1)
- carotid stenosis (1)
- carotid ultrasound (1)
- caspase activation (1)
- cbt (1)
- cerebral microbleeds (1)
- cerebrovascular diseases (1)
- childhood (1)
- children (1)
- chromosome 11Q13 (1)
- chronic cerebrovascular disease (1)
- chronic disorders (1)
- chronic respiratory-diseases (1)
- chronic urticaria (1)
- circadian rhythm (1)
- circulating micrornas (1)
- clinical measurement in health technology (1)
- clinical practice (1)
- clinical risk score (1)
- clinical routine data (1)
- clinical trial (1)
- clinical-practice (1)
- cloud-native (1)
- coagulation (1)
- cognition (1)
- cohort study (1)
- colorectal cancer (1)
- community detection (1)
- comorbid diseases (1)
- comparability (1)
- comprehension (1)
- computer science (1)
- condition prediction (1)
- cornea verticillata (1)
- cortisol (1)
- course of recovery (1)
- crantiectomy (1)
- cross-sectional studies (1)
- crowdsourcing (1)
- cyber-physical systems (1)
- data collection (1)
- data stream processing (1)
- death (1)
- decompressive surgery (1)
- degree of stenosis (1)
- delivery mode (1)
- demography (1)
- dependency (1)
- deployment (1)
- depression (1)
- dermatitis (1)
- diabetes (1)
- diabetic mouse (1)
- diagnosis (1)
- dialysis (1)
- digital transformation of health and care (1)
- disease score (1)
- disease severity (1)
- drug therapies (1)
- drug therapy (1)
- dual guidance (1)
- dysphagia (1)
- early-life (1)
- early-onset gastric cancer patients (1)
- echocardiography (1)
- ecological momentary assessments (1)
- ecological momentary assessments (EMA) (1)
- education (1)
- ehealth (1)
- ejection fraction (1)
- elderly (1)
- electrodermal activity (1)
- emotion regulation (1)
- end-user programming (1)
- endoglin (1)
- endovascular treatment (1)
- environmental sound (1)
- enzyme replacement therapy (1)
- erythropoietin (1)
- euroaspire (1)
- european birth cohorts (1)
- event rates (1)
- evidence‐based medicine (1)
- exacebrated respiratory-disease (1)
- exercise (1)
- exercise program (1)
- exercise training (1)
- explainable machine learning (1)
- expression (1)
- extracorporeal membrane oxygenation (ECMO) (1)
- eye tracking (1)
- factor VIII (1)
- factor-V-Leiden (1)
- family caregiver (1)
- family caregivers (1)
- family physicians (1)
- fatal cardiovascular disease (1)
- fatty liver disease (1)
- feasibility (1)
- ferritin (1)
- fibrosis (1)
- filaggrin mutations (1)
- fitness trackers (1)
- follow up (1)
- follow-up (1)
- form health survey (1)
- frailty (1)
- gastric cancer in young patients (1)
- gastroesophageal reflux (1)
- gastroesophageal reflux disease (1)
- gender (1)
- gene polymorphism (1)
- general practice (1)
- genomewide association (1)
- geographic information science (1)
- geospatial data (1)
- german clinical cancer registry group (1)
- gestational age (1)
- giant intracranial aneurysm (1)
- gingivitis (1)
- glucose control (1)
- glycaemic control (1)
- gradient boosting machine (1)
- guideline implementation (1)
- harmonization (1)
- hay fever (1)
- head and neck cancer (1)
- health care service research (1)
- health literacy (1)
- health sciences (1)
- health tracker (1)
- healthcare (1)
- heart (1)
- heart transplantation (1)
- heart valve prosthesis (1)
- heart valve repair (1)
- heme oxygenase-1 (1)
- hemicraniectomy (1)
- hemoglobin (1)
- hemorrhagic stroke (1)
- home isolation (1)
- home-based-rehabilitation (1)
- hospital medical complications (1)
- hospitalization (1)
- hospitals (1)
- house dust mite allergy (1)
- human brian endothelium (1)
- human-centered design (1)
- hypertrophic cardiomyopathy (1)
- hypoxia (1)
- illness experience (1)
- immune-responses (1)
- immunoglobulin-e (1)
- immunological reactivity (1)
- impact (1)
- inattention/hyperactivity (1)
- independent marker (1)
- indicators (1)
- infant growth (1)
- infection (1)
- infection surveillance (1)
- inflammation (1)
- informal care (1)
- informal caregiving (1)
- informed consent (1)
- injury (1)
- integraed care (1)
- intelligence (1)
- intensive care medicine (1)
- intensive care unit (1)
- inter-rater reliability (1)
- internet of things (1)
- intersession experiences (1)
- intersession processes (1)
- intervention (1)
- interview (1)
- intracerebral hemorrhage (1)
- ischemic-stroke (1)
- juvenile myoclonic epilepsy (1)
- kidney disease (1)
- kidney function (1)
- koronare Herzerkrankung (1)
- late-onset (1)
- latent change (1)
- left ventricular geometric abnormality (1)
- left ventricular geometry (1)
- left ventricular performance (1)
- left ventricular remodeling (1)
- length of stenosis (1)
- life style (1)
- lifestyle (1)
- loneliness (1)
- long-term survivors (1)
- longitudinal decrease (1)
- longitudinal studies (1)
- low birth weight (1)
- m-Health (1)
- malignant MCA infarct (1)
- marathon running (1)
- mechanical thrombectomy (1)
- mechanisms (1)
- medical analytics (1)
- medical complications (1)
- medical data integration center (1)
- medical device regulation (1)
- medical device software (1)
- medical informatics initiative (1)
- medical rehabilitation (1)
- melatonin (1)
- mellitus (1)
- mental disorders (1)
- mental effort (1)
- mental health monitoring (1)
- mental illness (1)
- metastatic (1)
- meta‐analysis (1)
- miR-122 (1)
- migration (1)
- mineralocorticoid antagonist (1)
- minimally invasive surgery (1)
- mobile app (1)
- mobile application (1)
- mobile apps (1)
- mobile crowdsensing (MCS) (1)
- mobile healthcare application (1)
- mobile operating system differences (1)
- mobile phone (1)
- mobility (1)
- models (1)
- moderate (1)
- molecular imaging (1)
- mortality/survival (1)
- mothers (1)
- multicenter (1)
- multidisciplinary (1)
- multifactorial (1)
- multimodal (1)
- multimodal data (1)
- multimodal intervention (1)
- multimorbidity (1)
- multi‑center cohort study (1)
- muscle strength (1)
- myocardial work efficiency (1)
- myocarditis (1)
- myokardiale Arbeit (1)
- national health survey (1)
- natriuretic peptide levels (1)
- neoadjuvant therapy (1)
- noise measurement (1)
- non-cancer controls (1)
- non-personalised tips (1)
- normal values (1)
- nursing home (1)
- offspring (1)
- old patients (1)
- older-adults (1)
- oncology (1)
- openEHR (1)
- oral hygiene (1)
- organ dysfunktion (1)
- osteopontin (1)
- outcome (1)
- pain questionnaire (1)
- pancreatic cancer (1)
- pancreatic surgery (1)
- pandemia (1)
- parenting stress (1)
- paroxysmal atrial fibrillation (1)
- passive data (1)
- patient education (1)
- patients' experience (1)
- patients’ awareness (1)
- peer review (1)
- perinatal (1)
- perioperative changes (1)
- perioperative therapy (1)
- peripheral artery disease (1)
- personalized medicine (1)
- pharmacotherapy (1)
- photoplethysmography (1)
- physical activity trajectories (1)
- physical health (1)
- physician feedback (1)
- physicians’ awareness (1)
- pilot project (1)
- platelets (1)
- pneumonia (1)
- point-of-care echocardiography (1)
- polysensitization (1)
- population-based (1)
- population-based studies (1)
- population-based study (1)
- postoperativ (1)
- power (1)
- prediction (1)
- predictive value (1)
- preschool children (1)
- preserved ejection fraction (1)
- preterm children (1)
- prevention (1)
- primary care (1)
- primary prevention (1)
- primary-care physicians (1)
- probiotic prophylaxis (1)
- probiotics (1)
- process model (1)
- process model comprehension (1)
- processing pipeline (1)
- production machines (1)
- prognosis (1)
- proteinuria (1)
- psycho-oncology (1)
- psychological interventions (1)
- psychology (1)
- psychotherapy (1)
- public health (1)
- public mental health (1)
- pulmonary hypertension (1)
- pulmonary rehabilitation (1)
- quality (1)
- quality assurance (1)
- quality indicators (1)
- quality of health care (1)
- quality-of-care (1)
- questionnaire assessment (1)
- questionnaire development (1)
- randomized controlled trial (1)
- randomized controlled-trial (1)
- rankin scale (1)
- rare diseases (1)
- reference architecture (1)
- reference data (1)
- register (1)
- registries (1)
- registry (1)
- regression analysis (1)
- rehabilitation (1)
- relapse (1)
- renal disease (1)
- renal fibrosis (1)
- reperfusion injury (1)
- resistance training (1)
- resource (1)
- review (1)
- risk factor (1)
- risk factor control (1)
- risk prediction scores (1)
- risk-factors (1)
- sample (1)
- scalability (1)
- scale (1)
- school-based prevention (1)
- second line antibiotics (1)
- sedentary behavior (1)
- self help (1)
- self-efficacy (1)
- self-employed (1)
- self-injury (1)
- self-management (1)
- self-monitoring (1)
- semantic interoperability (1)
- sensor (1)
- sensor data (1)
- sensor networks (1)
- septal hypertrophy (1)
- severe sepsis (1)
- severity (1)
- sex (1)
- sex addiction (1)
- sex differences (1)
- shedding (1)
- signs and symptoms (1)
- small business (1)
- smart mobile devices (1)
- smart-phone (1)
- smartphone app (1)
- smartphone communication (1)
- smartwatch (1)
- smoking-cessation (1)
- social media use (1)
- social well-being (1)
- soldiers (1)
- stream processing (1)
- strength and difficulties (1)
- stress (1)
- stroke care (1)
- stroke register (1)
- stroke unit (1)
- stroke unit care (1)
- stroke, acute (1)
- stroke-associated pneumonia (1)
- study-group ADSR (1)
- sudden cardiac death (1)
- surgical aneurysm treatment (1)
- survey (1)
- survey instrument (1)
- survival (1)
- symptoms (1)
- system architecture design (1)
- systolic dysfunction (1)
- task force (1)
- tele-medicine (1)
- telehealth (1)
- telemedicine (1)
- telemedicine network (1)
- term (1)
- term mortality (1)
- territory infaction (1)
- time (1)
- time series (1)
- time trends (1)
- tinnitus research (1)
- tinnitus therapy (1)
- tolerability (1)
- training curriculum (1)
- transient ischemic attack (1)
- treatment (1)
- under-dosing (1)
- universal prevention (1)
- update (1)
- urinary protein excretion (1)
- usability study (1)
- uveal melanoma (1)
- vascular access (1)
- vascular disease (1)
- venous thrombosis (1)
- ventricular assist device (1)
- violence (1)
- visual analytics (1)
- wearable (1)
- wheeze (1)
- wheezing (1)
- women (1)
- work capacity evaluation (1)
- young children (1)
- young patients (1)
Institute
- Institut für Klinische Epidemiologie und Biometrie (146) (remove)
Sonstige beteiligte Institutionen
- Clinical Trial Center (CTC) / Zentrale für Klinische Studien Würzburg (ZKSW) (5)
- Klinische Studienzentrale (Universitätsklinikum) (2)
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany (1)
- Interdisziplinäre Zentrum für Klinische Forschung (IZKF) (1)
- Medizinische Klinik und Poliklinik 1, Abteilung Kardiologie (1)
- Medizinische Klinik und Poliklinik 1, Abteilung Nephrologie (1)
- Servicezentrum Medizin-Informatik (1)
- Servicezentrum Medizin-Informatik (Universitätsklinikum) (1)
- Universitätsklinikum Würzburg (UKW) (1)
Background and objectives
Bullous pemphigoid (BP) is associated with neuropsychiatric disorders. Other comorbid diseases are discussed controversially. We evaluated the prevalence of comorbidity in BP patients in a representative area of Germany.
Patients and methods
Medical files of all BP patients treated at the Department of Dermatology, University Hospital Würzburg, Germany, between June 2002 and May 2013 were retrospectively reviewed. Bullous pemphigoid was diagnosed based on established criteria. For each patient, two controls were individually matched. Records were evaluated for age, sex, laboratory values, concomitant medication and comorbidity. Conditional logistic regression, multivariable regression analysis and complex regression models were performed to compare results.
Results
300 BP patients were identified and compared to 583 controls. Bullous pemphigoid was associated with neuropsychiatric disorders as well as laboratory abnormalities including leukocytosis and eosinophilia. Importantly, a highly significant association of BP with anemia (OR 2.127; 95 % CI 1.532–2.953) and renal impairment (OR 2.218; 95 % CI 1.643–2.993) was identified. No association was found with malignancy and arterial hypertension.
Conclusions
Our data revealed an increased frequency of anemia and renal impairment in BP patients. In accordance with previous studies the strong association for neuropsychiatric disorders was confirmed (p < 0.0005).
Mobile health technologies have become more and more important in psychotherapy research and practice. The market is being flooded by several psychotherapeutic online services for different purposes. However, mobile health technologies are particularly suitable for data collection and monitoring, as data can be recorded economically in real time. Currently, there is no appropriate method to assess intersession experiences systematically in psychotherapeutic practice. The aim of our project was the development of a smartphone application framework for systematic recording and controlling of intersession experiences. Intersession-Online, an iOS- and Android-App, offers the possibility to collect data on intersession experiences easily, to provide the results to therapists in an evaluated form and, if necessary, to induce or interrupt intersession experiences with the primary aim to improve outcome of psychotherapy. In general, the smartphone application could be a helpful, evidence-based tool for research and practice. Overall speaking, further research to investigate the efficacy of Intersession-Online is necessary.
Within the healthcare environment, mobile health (mHealth) applications (apps) are becoming more and more important. The number of new mHealth apps has risen steadily in the last years. Especially the COVID-19 pandemic has led to an enormous amount of app releases. In most countries, mHealth applications have to be compliant with several regulatory aspects to be declared a “medical app”. However, the latest applicable medical device regulation (MDR) does not provide more details on the requirements for mHealth applications. When developing a medical app, it is essential that all contributors in an interdisciplinary team — especially software engineers — are aware of the specific regulatory requirements beforehand. The development process, however, should not be stalled due to integration of the MDR. Therefore, a developing framework that includes these aspects is required to facilitate a reliable and quick development process. The paper at hand introduces the creation of such a framework on the basis of the Corona Health and Corona Check apps. The relevant regulatory guidelines are listed and summarized as a guidance for medical app developments during the pandemic and beyond. In particular, the important stages and challenges faced that emerged during the entire development process are highlighted.
A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0–2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51% and 2 to 38%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers.
Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educational counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasibility study, we implemented educational material and self-help advice in a smartphone app. Participants used the educational smartphone app unsupervised during their daily routine over a period of four months. Comparing the tinnitus outcome measures before and after smartphone-guided treatment, we measured changes in tinnitus-related distress, but not in tinnitus loudness. Improvements on the Tinnitus Severity numeric rating scale reached an effect size of 0.408, while the improvements on the Tinnitus Handicap Inventory (THI) were much smaller with an effect size of 0.168. An analysis of user behavior showed that frequent and intensive use of the app is a crucial factor for treatment success: participants that used the app more often and interacted with the app intensively reported a stronger improvement in the tinnitus. Between study allocation and final assessment, 26 of 52 participants dropped out of the study. Reasons for the dropouts and lessons for future studies are discussed in this paper.
(1) Background: The aim of this study is to assess perioperative therapy in stage IA-III pancreatic cancer cross-validating the German Cancer Registry Group of the Society of German Tumor Centers — Network for Care, Quality, and Research in Oncology, Berlin (GCRG/ADT) and the National Cancer Database (NCDB). (2) Methods: Patients with clinical stage IA-III PDAC undergoing surgery alone (OP), neoadjuvant therapy (TX) + surgery (neo + OP), surgery+adjuvantTX (OP + adj) and neoadjuvantTX + surgery + adjuvantTX (neo + OP + adj) were identified. Baseline characteristics, histopathological parameters, and overall survival (OS) were evaluated. (3) Results: 1392 patients from the GCRG/ADT and 29,081 patients from the NCDB were included. Patient selection and strategies of perioperative therapy remained consistent across the registries for stage IA-III pancreatic cancer. Combined neo + OP + adj was associated with prolonged OS as compared to neo + OP alone (17.8 m vs. 21.3 m, p = 0.012) across all stages in the GCRG/ADT registry. Similarly, OS with neo + OP + adj was improved as compared to neo + OP in the NCDB registry (26.4 m vs. 35.4 m, p < 0.001). (4) Conclusion: The cross-validation study demonstrated similar concepts and patient selection criteria of perioperative therapy across clinical stages of PDAC. Neoadjuvant therapy combined with adjuvant therapy is associated with improved overall survival as compared to either therapy alone.
Interactive system for similarity-based inspection and assessment of the well-being of mHealth users
(2021)
Recent digitization technologies empower mHealth users to conveniently record their Ecological Momentary Assessments (EMA) through web applications, smartphones, and wearable devices. These recordings can help clinicians understand how the users' condition changes, but appropriate learning and visualization mechanisms are required for this purpose. We propose a web-based visual analytics tool, which processes clinical data as well as EMAs that were recorded through a mHealth application. The goals we pursue are (1) to predict the condition of the user in the near and the far future, while also identifying the clinical data that mostly contribute to EMA predictions, (2) to identify users with outlier EMA, and (3) to show to what extent the EMAs of a user are in line with or diverge from those users similar to him/her. We report our findings based on a pilot study on patient empowerment, involving tinnitus patients who recorded EMAs with the mHealth app TinnitusTips. To validate our method, we also derived synthetic data from the same pilot study. Based on this setting, results for different use cases are reported.
The new coronavirus (COVID-19) pandemic and the resulting response measures have led to severe limitations of people's exercise possibilities with diminished physical activity (PA) and increased sedentary behavior (SB). Since for migrant groups in Germany, no data is available, this study aimed to investigate factors associated with changes in PA and SB in a sample of Turkish descent. Participants of a prospective cohort study (adults of Turkish descent, living in Berlin, Germany) completed a questionnaire regarding COVID-19 related topics including PA and SB since February 2020. Changes in PA and SB were described, and sociodemographic, migrant-related, and health-related predictors of PA decrease and SB increase were determined using multivariable regression analyses. Of 106 participants, 69% reported a decline of PA, 36% reported an increase in SB. PA decrease and SB increase seemed to be associated with inactivity before the pandemic as well as with the female sex. SB increase appeared to be additionally associated with educational level and BMI. The COVID-19 pandemic and the response measures had persistent detrimental effects on this migrant population. Since sufficient PA before the pandemic had the strongest association with maintaining PA and SB during the crisis, the German government and public health professionals should prioritize PA promotion in this vulnerable group.
For COVID-19 patients who remain symptomatic after the acute phase, pulmonary rehabilitation (PR) is recommended. However, only a few studies have investigated the effectiveness of PR, especially considering the duration between the acute phase of COVID-19 and the onset of rehabilitation, as well as the initial severity. This prospective observational study evaluated the efficacy of PR in patients after COVID-19. A total of 120 still-symptomatic patients referred for PR after overcoming acute COVID-19 were asked to participate, of whom 108 (mean age 55.6 ± 10.1 years, 45.4% female) consented. The patients were assigned to three groups according to the time of referral and initial disease severity (severe acute; severe after interval; mild after interval). The primary outcome was dyspnea. Secondary outcomes included other respiratory disease symptoms, physical capacity, lung function, fatigue, quality of life (QoL), depression, and anxiety. Furthermore, patients rated the overall effectiveness of PR and their subjective change in health status. At the end of PR, we detected improvements with large effect sizes in exertional dyspnea, physical capacity, QoL, fatigue, and depression in the overall group. Other parameters changed with small to medium effect sizes. PR was effective after acute COVID-19 in all three groups analyzed.
Occurrence of mental illness and mental health risks among the self-employed: a systematic review
(2021)
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.