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  • 1
    In: Der Nervenarzt, Springer Science and Business Media LLC, Vol. 93, No. 3 ( 2022-03), p. 279-287
    Abstract: Ward-equivalent treatment (StäB), a form of crisis resolution and home treatment in Germany, has been introduced in 2018 as a new model of mental health service delivery for people with an indication for inpatient care. The rapid progress in the field of information and communication technology offers entirely new opportunities for innovative digital mental health care, such as telemedicine, eHealth, or mHealth interventions. Objective This review aims to provide a comprehensive overview of novel digital forms of service delivery that may contribute to a personalized delivery of StäB and improving clinical and social outcomes as well as reducing direct and indirect costs. Method This work is based on a narrative review. Results Four primary digital forms of service delivery have been identified that can be used for personalized delivery of StäB: (1) communication, continuity of care, and flexibility through online chat and video call; (2) monitoring of symptoms and behavior in real-time through ecological momentary assessment (EMA); (3) use of multimodal EMA data to generate and offer personalized feedback on subjective experience and behavioral patterns as well as (4) adaptive ecological momentary interventions (EMI) tailored to the person, moment, and context in daily life. Conclusion New digital forms of service delivery have considerable potential to increase the effectiveness and cost-effectiveness of crisis resolution, home treatment, and assertive outreach. An important next step is to model and initially evaluate these novel digital forms of service delivery in the context of StäB and carefully investigate their quality from the user perspective, safety, feasibility, initial process and outcome quality as well as barriers and facilitators of implementation.
    Type of Medium: Online Resource
    ISSN: 0028-2804 , 1433-0407
    RVK:
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1462945-8
    detail.hit.zdb_id: 123291-5
    SSG: 2,1
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  • 2
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Vol. 66, No. 4 ( 2023-04), p. 371-378
    In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, Springer Science and Business Media LLC, Vol. 66, No. 4 ( 2023-04), p. 371-378
    Abstract: In recent years, efforts in the field of public mental health have increased that seek to promote mental health and mental health literacy at population level and yield advances in the prevention, treatment and care of mental health conditions. This paper provides an overview of contemporary conceptualisations of indicators and determinants of public mental health as well as population-based intervention strategies from an international perspective. Current conceptual and methodological challenges of so-called high-risk, whole-population and vulnerable population strategies are critically discussed. Future efforts in research, policy and practice need to address fundamental causes of social and health inequalities, drawing on all societal fields, to contribute to improving population mental health.
    Type of Medium: Online Resource
    ISSN: 1436-9990 , 1437-1588
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1470303-8
    SSG: 20,1
    SSG: 8,1
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  • 3
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 4 ( 2006-04-01), p. 853-857
    Abstract: OBJECTIVE—The α2-Heremans-Schmid glycoprotein (AHSG; fetuin-A in animals) impairs insulin signaling in vitro and in rodents. Whether AHSG is associated with insulin resistance in humans is under investigation. In an animal model of diet-induced obesity that is commonly associated with hepatic steatosis, an increase in Ahsg mRNA expression was observed in the liver. Therefore, we hypothesized that the AHSG plasma protein, which is exclusively secreted by the liver in humans, may not only be associated with insulin resistance but also with fat accumulation in the liver. RESEARCH DESIGN AND METHODS—Data from 106 healthy Caucasians without type 2 diabetes were included in cross-sectional analyses. A subgroup of 47 individuals had data from a longitudinal study. Insulin sensitivity was measured by a euglycemic-hyperinsulinemic clamp, and liver fat was determined by 1H magnetic resonance spectroscopy. RESULTS—AHSG plasma levels, adjusted for age, sex, and percentage of body fat, were higher in subjects with impaired glucose tolerance compared with subjects with normal glucose tolerance (P = 0.006). AHSG plasma levels were negatively associated with insulin sensitivity (r = −0.22, P = 0.03) in cross-sectional analyses. Moreover, they were positively associated with liver fat (r = 0.27, P = 0.01). In longitudinal analyses, under weight loss, a decrease in liver fat was accompanied by a decrease in AHSG plasma concentrations. Furthermore, high AHSG levels at baseline predicted less increase in insulin sensitivity (P = 0.02). CONCLUSIONS—We found that high AHSG plasma levels are associated with insulin resistance in humans. Moreover, AHSG plasma levels are elevated in subjects with fat accumulation in the liver. This is consistent with a potential role of AHSG as a link between fatty liver and insulin resistance.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
    detail.hit.zdb_id: 1490520-6
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  • 4
    In: European Psychiatry, Royal College of Psychiatrists, Vol. 64, No. 1 ( 2021)
    Abstract: Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We investigated the associations between social isolation, COVID-19-related cognitive preoccupation, worries, and anxiety, objective social risk indicators, and psychological distress, as well as use of, and attitude toward, mobile health (mHealth) interventions in youth. Methods Data were collected as part of the “Mental Health And Innovation During COVID-19 Survey”—a cross-sectional panel study including a representative sample of individuals aged 16–25 years ( N  = 666; M age  = 21.3; assessment period: May 5, 2020 to May 16, 2020). Results Overall, 38% of youth met criteria for moderate or severe psychological distress. Social isolation worries and anxiety, and objective risk indicators were associated with psychological distress, with evidence of dose–response relationships for some of these associations. For instance, psychological distress was progressively more likely to occur as levels of social isolation increased (reporting “never” as reference group: “occasionally”: adjusted odds ratio [aOR] 9.1, 95% confidence interval [CI] 4.3–19.1, p   〈  0.001; “often”: aOR 22.2, CI 9.8–50.2, p   〈  0.001; “very often”: aOR 42.3, CI 14.1–126.8, p   〈  0.001). There was evidence that psychological distress, worries, and anxiety were associated with a positive attitude toward using mHealth interventions, whereas psychological distress, worries, and anxiety were associated with actual use. Conclusions Public health measures during pandemics may be associated with poor mental health outcomes in youth. Evidence-based digital interventions may help mitigate the negative psychosocial impact without risk of viral infection given there is an objective need and subjective demand.
    Type of Medium: Online Resource
    ISSN: 0924-9338 , 1778-3585
    RVK:
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2021
    detail.hit.zdb_id: 2005377-0
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  • 5
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  European Journal of Cardiovascular Nursing Vol. 19, No. 7 ( 2020-10), p. 629-637
    In: European Journal of Cardiovascular Nursing, Oxford University Press (OUP), Vol. 19, No. 7 ( 2020-10), p. 629-637
    Abstract: Most patients with advanced heart failure are ill-prepared and poorly supported during the end of life. To date, research has focused primarily on generalized patient accounts of the management or self-care phase of the syndrome. Little research has examined the end of life in depth or from the perspectives of family members. Aims The purpose of this study is to describe how people diagnosed with heart failure and their family members describe uncertainty related to impending death. Methods and results A narrative inquiry was undertaken using a social constructionist perspective. Twenty participants took part in over 60 interviews: 12 participants with heart failure (eight male and four female; mean = 67.3 years) and eight family members (mean = 61.6 years) engaged in two in-depth interviews, approximately 3–4 months apart, followed by a telephone follow-up 2–3 months later. Six key themes/storylines were identified. These included: prognosis messages received from physicians; whenever I die, I die; loss isn’t new to me but … ; carrying on amidst the fragility of life; ultimately living not knowing; and the need to prepare. Conclusion The six key storylines of death and dying with advanced heart failure were consistent for both patients and family members. There was a desire for better communication with physicians. Many participants were critical of how the prognosis of advanced heart failure was communicated to them, even if they anticipated the news. Participants wanted frank, open conversations with their healthcare providers that both acknowledged that they were at end of life but did not remove all hope.
    Type of Medium: Online Resource
    ISSN: 1474-5151 , 1873-1953
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2099328-6
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  • 6
    Online Resource
    Online Resource
    SAGE Publications ; 2020
    In:  Qualitative Health Research Vol. 30, No. 5 ( 2020-04), p. 655-665
    In: Qualitative Health Research, SAGE Publications, Vol. 30, No. 5 ( 2020-04), p. 655-665
    Abstract: Communicating openly and directly about illness comes easily for some patients, whereas for others fear of disclosure keeps them silent. In this article, we discuss findings about the role of keeping secrets regarding health and illness. These findings were part of a larger project on how people with life-threatening illnesses re-story their lives. A narrative approach drawing on Frank’s dialogical narrative analysis and Riesman’s inductive approach was used. Interviews were conducted with 32 participants from three populations: chronic kidney disease, HIV/AIDS, and cancer. Findings include case exemplars which suggest keeping secrets is a social practice that acts along continuums of connecting–isolating, protecting–harming, and empowering–imprisoning. Keeping secrets about illness is a normative practice that is negotiated with each encounter. Findings call health-care providers to rethink the role of secrets for patients by considering patient privilege, a person’s right to take the lead in revealing or concealing their health and illness experience.
    Type of Medium: Online Resource
    ISSN: 1049-7323 , 1552-7557
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2010333-5
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  • 7
    Online Resource
    Online Resource
    RCN Publishing Ltd. ; 2013
    In:  Nurse Researcher Vol. 21, No. 1 ( 2013-09), p. 23-28
    In: Nurse Researcher, RCN Publishing Ltd., Vol. 21, No. 1 ( 2013-09), p. 23-28
    Type of Medium: Online Resource
    ISSN: 1351-5578 , 2047-8992
    Language: English
    Publisher: RCN Publishing Ltd.
    Publication Date: 2013
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  • 8
    In: JMIR Mental Health, JMIR Publications Inc., Vol. 8, No. 8 ( 2021-8-5), p. e25650-
    Abstract: Digital interventions offer new avenues for low-threshold prevention and treatment in young people. Ecological momentary interventions (EMIs) represent a powerful approach that allows for adaptive, real-time, and real-world delivery of intervention components in daily life by real-time processing of ecological momentary assessment (EMA) data. Compassion-focused interventions (CFIs) may be particularly amenable to translation into an EMI to strengthen emotional resilience and modify putative risk mechanisms, such as stress sensitivity, in the daily lives of young help-seeking individuals. Objective This study aims to investigate the feasibility, safety, and initial therapeutic effects of a novel, accessible, transdiagnostic, ecological momentary CFI for improving emotional resilience to stress (EMIcompass). Methods In this uncontrolled pilot study, help-seeking youth with psychotic, depressive, or anxiety symptoms were offered the EMIcompass intervention in addition to treatment as usual. The EMIcompass intervention consisted of a 3-week EMI (including enhancing, consolidating, and EMA-informed interactive tasks) administered through a mobile health app and three face-to-face sessions with a trained psychologist intended to provide guidance and training on the CFI exercises presented in the app (ie, training session, follow-up booster session, and review session). Results In total, 10 individuals (mean age 20.3 years, SD 3.8; range 14-25) were included in the study. Most (8/10, 80%) participants were satisfied and reported a low burden of app usage. No adverse events were observed. In approximately one-third of all EMAs, individuals scored high on stress, negative affect, or threat anticipation during the intervention period, resulting in real-time, interactive delivery of the CFI intervention components in addition to weekly enhancing and daily consolidating tasks. Although the findings should be interpreted with caution because of the small sample size, reduced stress sensitivity, momentary negative affect, and psychotic experiences, along with increased positive affect, were found at postintervention and the 4-week follow-up. Furthermore, reductions in psychotic, anxiety, and depressive symptoms were found (r=0.30-0.65). Conclusions Our findings provide evidence on the feasibility and safety of the EMIcompass intervention for help-seeking youth and lend initial support to beneficial effects on stress sensitivity and mental health outcomes. An exploratory randomized controlled trial is warranted to establish the feasibility and preliminary evidence of its efficacy.
    Type of Medium: Online Resource
    ISSN: 2368-7959
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2798262-2
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  • 9
    In: JMIR Mental Health, JMIR Publications Inc., Vol. 8, No. 11 ( 2021-11-19), p. e30309-
    Abstract: Negative symptoms occur in individuals at ultrahigh risk (UHR) for psychosis. Although there is evidence that observer ratings of negative symptoms are associated with level of functioning, the predictive value of subjective experience in daily life for individuals at UHR has not been studied yet. Objective This study therefore aims to investigate the predictive value of momentary manifestations of negative symptoms for clinical outcomes in individuals at UHR. Methods Experience sampling methodology was used to measure momentary manifestations of negative symptoms (blunted affective experience, lack of social drive, anhedonia, and social anhedonia) in the daily lives of 79 individuals at UHR. Clinical outcomes (level of functioning, illness severity, UHR status, and transition status) were assessed at baseline and at 1- and 2-year follow-ups. Results Lack of social drive, operationalized as greater experienced pleasantness of being alone, was associated with poorer functioning at the 2-year follow-up (b=−4.62, P=.01). Higher levels of anhedonia were associated with poorer functioning at the 1-year follow-up (b=5.61, P=.02). Higher levels of social anhedonia were associated with poorer functioning (eg, disability subscale: b=6.36, P=.006) and greater illness severity (b=−0.38, P=.045) at the 1-year follow-up. In exploratory analyses, there was evidence that individuals with greater variability of positive affect (used as a measure of blunted affective experience) experienced a shorter time to remission from UHR status at follow-up (hazard ratio=4.93, P=.005). Conclusions Targeting negative symptoms in individuals at UHR may help to predict clinical outcomes and may be a promising target for interventions in the early stages of psychosis.
    Type of Medium: Online Resource
    ISSN: 2368-7959
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2798262-2
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  • 10
    In: JAMA Ophthalmology, American Medical Association (AMA), Vol. 139, No. 12 ( 2021-12-01), p. 1299-
    Type of Medium: Online Resource
    ISSN: 2168-6165
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2021
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