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Introduction
Hip and knee osteoarthritis are associated with functional limitations, pain and restrictions in quality of life and the ability to work. Furthermore, with growing prevalence, osteoarthritis is increasingly causing (in)direct costs. Guidelines recommend exercise therapy and education as primary treatment strategies. Available options for treatment based on physical activity promotion and lifestyle change are often insufficiently provided and used. In addition, the quality of current exercise programmes often does not meet the changing care needs of older people with comorbidities and exercise adherence is a challenge beyond personal physiotherapy. The main objective of this study is to investigate the short- and long-term (cost-)effectiveness of the SmArt-E programme in people with hip and/or knee osteoarthritis in terms of pain and physical functioning compared to usual care.
Methods
This study is designed as a multicentre randomized controlled trial with a target sample size of 330 patients. The intervention is based on the e-Exercise intervention from the Netherlands, consists of a training and education programme and is conducted as a blended care intervention over 12 months. We use an app to support independent training and the development of self-management skills. The primary and secondary hypotheses are that participants in the SmArt-E intervention will have less pain (numerical rating scale) and better physical functioning (Hip Disability and Osteoarthritis Outcome Score, Knee Injury and Osteoarthritis Outcome Score) compared to participants in the usual care group after 12 and 3 months. Other secondary outcomes are based on domains of the Osteoarthritis Research Society International (OARSI). The study will be accompanied by a process evaluation.
Discussion
After a positive evaluation, SmArt-E can be offered in usual care, flexibly addressing different care situations. The desired sustainability and the support of the participants’ behavioural change are initiated via the app through audio-visual contact with their physiotherapists. Furthermore, the app supports the repetition and consolidation of learned training and educational content. For people with osteoarthritis, the new form of care with proven effectiveness can lead to a reduction in underuse and misuse of care as well as contribute to a reduction in (in)direct costs.
Trial registration
German Clinical Trials Register, DRKS00028477. Registered on August 10, 2022.
This study explores the intriguing relationship between personality traits, self-rated fitness (SRF), and physical activity (PA) variables among German university students (N = 4244) and sheds light on the impact of personality on adherence to PA guidelines. Employing an online cross-sectional study, the short-form of the Big Five Inventory-2 assessed five domains of personality traits (Extraversion, Negative Emotionality, Agreeableness, conscientiousness, and Open-Mindedness). PA, including sitting time, was assessed using the International Physical Activity Questionnaire (short-form). SRF and muscle-strengthening activities (MSA) were assessed with one item each. Multiple linear and logistic regression analyses examined associations of individual personality trait domains and all domains combined with SFR, PA variables, and adherence to PA guidelines, controlling for sociodemographic, behavioral, and (mental) health covariates. Most reliably, Extraversion and Conscientiousness revealed positive associations with PA variables, while Negative Emotionality yielded inverse relationships with PA variables. For instance, each unit increase in Extraversion corresponded to an additional 17 min of weekly MSA. On the contrary, daily sitting time was unrelated to personality. Of note, high Open-Mindedness was associated with lower odds for adhering to current PA guidelines. The findings have implications for developing targeted interventions that promote a physically active lifestyle and support students’ well-being and academic success.
Studien haben wiederholt auf eine hohe Beschwerdelast Studierender hingewiesen und Hochschulen veranlasst, sich zunehmend im studentischen Gesundheitsmanagement zu engagieren, das darauf abzielt, gesundheitsfördernde Strukturen zu entwickeln sowie individuelle Ressourcen im Setting Hochschule zu fördern. Die körperliche Aktivität und mentale Gesundheit Studierender stellen hierfür Ansatzpunkte dar. International zeigen sich eindeutige Zusammenhänge zwischen dem Bewegungsverhalten Studierender und der psychischen Gesundheit, jedoch liegen bisher nur wenige nationale Erhebungen vor, was die Übertragbarkeit auf die deutsche Hochschullandschaft einschränkt. Dieser Beitrag untersucht, wie in dieser Zielgruppe die aktuellen Bewegungsempfehlungen, bestehend aus den Kategorien ausdauerorientierte körperliche Aktivitäten, Sitzzeiten und muskelkräftigende Aktivitäten, mit verschiedenen Indikatoren mentaler Gesundheit zusammenhängen.
Im Sommersemester 2019 nahmen 4.244 Studierende an einer hochschulweiten Umfrage teil. Neben dem Bewegungsverhalten wurden das Stresserleben erhoben und Screenings auf Kernelemente einer depressiven und angstbezogenen Störung sowie auf eine psychische Belastung durchgeführt. Positive Aspekte mentaler Gesundheit wurden über eine Skala zur Beurteilung studentischen Engagements erfasst. Als Assoziationsmaß wurden adjustierte Odds Ratios unter Berücksichtigung soziodemografischer und behavioraler Störvariablen berechnet.
Sämtliche Kriterien der Bewegungsempfehlungen werden von 9,6% der Studierenden erreicht. 48% der Befragten weisen ein hohes Stresserleben auf und 29% gelten als psychisch belastet. Das Befolgen aller Kriterien der Bewegungsempfehlungen ist mit signifikant geringeren Chancen für psychische Belastungsindikatoren assoziiert, wobei der stärkste Zusammenhang für depressive Symptome gefunden wurde. Studentisches Engagement war nicht signifikant mit dem Erreichen der Bewegungsempfehlungen assoziiert.
Die Ergebnisse bestätigen die hohe psychische Belastung Studierender und deuten das Optimierungspotenzial aus Sicht der Bewegungsförderung an. Hochschulen sollten die Studienbedingungen und das Gesundheitsverhalten der Studierenden systematisch und fortlaufend analysieren, um geeignete verhaltens- und verhältnisorientierte Maßnahmen wie bewegungsorientierte Lehre, Campusentwicklung und Ausbau des Hochschulsportangebots abzuleiten und zu evaluieren.
University students frequently engage in unhealthy behaviors. However, there is a lack of studies examining a wide range of their lifestyle characteristics by sex and academic level of study. This cross-sectional survey of students enrolled in BSc, MSc, or PhD programs at one university in Germany (N = 3389) assessed physical activity (PA), sedentary behavior (SB), nutrition, sleep quality, and alcohol, tobacco, and other drug (ATOD) use by sex and academic level and was conducted with EvaSys version 8.0. Chi-squared tests compared categorical variables by sex, and binary logistic regression analyses adjusted for sex with Bonferroni adjustments evaluated differences across academic level. Although 91% of students achieved the aerobic PA guidelines, only 30% achieved the muscle strengthening exercises (MSE) guidelines, and 44% had high SB. Likewise, <10% met the fruit and vegetable consumption (FVC) recommendations, >40% of students experienced impaired sleep, and >30% had hazardous alcohol consumption. Less than 20% of the sample achieved the guideline/recommendation of all three PA, MSE and SB. Some behaviors exhibited significant sex and academic level differences. The identified at-risk groups included males (lower FVC), females (eating more during stress), and BSc students (poorer nutrition/sleep quality, more ATOD use). Given the above findings, multipronged strategies are needed with an overarching focus highlighting the health–academic achievement links. Behavioral interventions and environmental policies are required to raise awareness and promote student health.
Beach handball is a young discipline that is characterized by numerous high-intensity actions. By following up on previous work, the objective was to perform in-depth analyses evaluating external load (e.g., distance traveled, velocity, changes in direction, etc.) in beach handball players. In cross-sectional analyses, data of 69 players belonging to the German national or prospective team were analyzed during official tournaments using a local positioning system (10 Hz) and inertial measurement units (100 Hz). Statistical analyses comprised the comparison of the first and second set and the effects of age and sex (female adolescents vs. male adolescents vs. male adults) and playing position (goalkeepers, defenders, wings, specialists, and pivots) on external load measures. We found evidence for reduced external workload during the second set of the matches (p = 0.005, ηp2 = 0.09), as indicated by a significantly lower player load per minute and number of changes in direction. Age/sex (p < 0.001, ηp2 = 0.22) and playing position (p < 0.001, ηp2 = 0.29) also had significant effects on external load. The present data comprehensively describe and analyze important external load measures in a sample of high-performing beach handball players, providing valuable information to practitioners and coaches aiming at improving athletic performance in this new sport.
Förderung evidenzbasierten Unterrichtens durch das Projekt „Lese-Sportler: mit PS in die Schule“
(2022)
Haiku of Maladisms
(2021)
Heading in soccer involves repetitive head accelerations that may be detrimental for brain health. One way to mitigate adverse effects may be to increase head-neck stabilization and thus reduce the kinematic response after intentional headers. This study aimed to (a) assess associations between neck strength and head kinematics and (b) evaluate an exercise intervention designed to increase strength and attenuate head acceleration during intentional heading in youth soccer players. In 22 athletes, we used accelerometers to assess associations between neck strength and peak linear acceleration (PLA). We attached the accelerometers to the occiput and sternum, allowing us to differentiate between total, trunk, and head PLA. Longitudinally, we evaluated the effects of a 14-week twice-weekly resistance training in a subsample of 14 athletes compared with regular soccer training (N = 13). Results showed that female athletes had lower isolated neck strength (p ≤ 0.004), lower functional neck strength (p ≤ 0.017), and higher total PLA during purposeful headers compared with males (17.2 ± 3.5 g and 13.0 ± 2.3 g, respectively, at 9.6 m·s−1 ball velocity during impact; p = 0.003). The intervention group showed moderate to large strength gains (η
= 0.16–0.42), resulting in lower PLA (total −2.4 g, trunk −0.8 g, and head −1.5 g) during headers. We conclude that a resistance training focusing on cervical and trunk musculature is practicable in youth soccer, elicits strength gains, and helps to mitigate PLA during purposeful heading. Results should encourage youth strength and conditioning professionals to incorporate neck exercises as a risk reduction strategy into their training routine.
Daughters and Mothers
(2020)
Background: Mental health is an emerging topic on university campuses, with students reporting higher levels of psychological distress than the general population of the same age. Increasing physical activity and reducing sedentary time have been proved promising measures to promote mental health in the general population. However, to derive and implement effective measures to promote mental health among university students, further exploration of the associations between physical activity, sedentary time, and perceived stress in this specific setting is needed.
Objective: This study aims to identify associations between physical activity, sedentary time, and perceived stress after controlling for sociodemographic and behavioral variables among university students in Germany. We hypothesize that perceived stress is inversely related to physical activity and positively associated with sedentary time. Furthermore, we hypothesize that combined associations of concurrently high physical activity and low sedentary time on perceived stress are stronger compared with either alone and that the association between physical activity and perceived stress depends on activity intensity.
Methods: We conducted cross-sectional analyses from a large-scale internet-based student health survey (n=4189; response rate=10.0%). Physical activity, sedentary time, and engaging in moderate and vigorous activity intensities were assessed using the International Physical Activity Questionnaire Short Form with categorization into low, intermediate, and high levels. We measured perceived stress using the 10-item Perceived Stress Scale (range 0-40).
Results: The results indicate that higher physical activity and lower sedentary time are associated with reduced levels of perceived stress. Following adjustment for gender, BMI, income, fruit and vegetable intake, alcohol consumption, and sleep quality, perceived stress scores were lower for students reporting high physical activity levels and low sedentary time compared with the least active and highly sedentary students (Perceived Stress Scale –2.2, 95% CI –2.9 to –1.5, P<.001 for physical activity and –1.1, CI 95% –1.7 to –0.5, P<.001 for sedentary time). Combined associations with perceived stress revealed that students concurrently reporting high total physical activity and low sedentary time reported the lowest perceived stress scores of all possible combinations following adjustment for confounders (Perceived Stress Scale –3.5, CI 95% –4.6 to –2.5, P<.001 compared with students reporting low physical activity levels and concurrently high sedentary time). Associations between vigorous physical activities and perceived stress were not stronger compared with moderate activity intensities.
Conclusions: Self-reported physical activity and low sedentary time are favorably associated with perceived stress, while the intensity of physical activities seems to be of minor importance. These results help to effectively implement health-promoting measures on campus among university students through increasing physical activity and reducing sedentary time.
Im Beitrag wird eine „Systematische Übersicht und Meta-Analyse von Querschnittsstudien zum Zusammenhang zwischen körperlicher Aktivität und psychischer Gesundheit bei Studierenden“ vorgestellt. Auf Grundlage von 18 internationalen Studien wird die Frage beantwortet, inwieweit sich positive Assoziationen zwischen körperlicher Aktivität und psychischer Gesundheit auch bei Studierenden bestätigen lassen. Hierbei zeigt sich, dass psychische Beschwerden bei Studierenden vor allem in Form eines erhöhten Stresserlebens, von depressiven Symptomen und Angststörungen auftreten. Die Studienlage verweist zwar auf einen engen Zusammenhang von psychischer Gesundheit und körperlicher Aktivität, allerdings wurde dieser Zusammenhang bei Studierenden bislang noch nicht adäquat nachgewiesen. Lediglich für den Einfluss von körperlicher Aktivität auf Angststörungen wird ein moderater Zusammenhang ersichtlich. Da Studierende, die unter depressiven Beschwerden leiden, ihr Studium eher abbrechen, lässt sich die Schlussfolgerung ziehen, dass körperliche Aktivität eine relevante Größe für den Studienerfolg darstellen kann. Allerdings fehlen derzeit noch großangelegte empirische Studien, die sich explizit auf das deutsche Hochschulsystem beziehen.
Prokrastination - Was tun?
(2019)
A new measurement system (horizontal displacement, time of flight, synchronicity—HDTS) was investigated regarding the latest changes to the international evaluation rules in trampoline gymnastics. It allows for the real-time measurement of objective criteria, such as flight time and landing position, without affecting the gymnast. The aim of this study was to investigate the temporal and spatial accuracy of a measurement tool via cross-validation. Temporal precision was additionally tested via high-speed video landing and takeoff, while a three-dimensional motion capturing system was incorporated for spatial precision. The Bland–Altman “limit of agreement approach” was used for the assessment of congruence between the measurement systems. The new measurement system presented an average spatial deviation of 3.2 cm and a temporal deviation between − 5.8 and + 6.4 ms for the landing and − 11.3 and + 11.3 ms for the takeoff. Given its temporal and spatial accuracy in determining flight time and landing position as identified through cross-validation, the novel HDTS system proved to be suitable for its use in trampoline competitions.
Despite growing interest in light-driven ion pumps for use in optogenetics, current estimates of their transport rates span two orders of magnitude due to challenges in measuring slow transport processes and determining protein concentration and/or orientation in membranes in vitro. In this study, we report, to our knowledge, the first direct quantitative measurement of light-driven Cl− transport rates of the anion pump halorohodopsin from Natronomonas pharaonis (NpHR). We used light-interfaced voltage clamp measurements on NpHR-expressing oocytes to obtain a transport rate of 219 (± 98) Cl−/protein/s for a photon flux of 630 photons/protein/s. The measurement is consistent with the literature-reported quantum efficiency of ∼30% for NpHR, i.e., 0.3 isomerizations per photon absorbed. To reconcile our measurements with an earlier-reported 20 ms rate-limiting step, or 35 turnovers/protein/s, we conducted, to our knowledge, novel consecutive single-turnover flash experiments that demonstrate that under continuous illumination, NpHR bypasses this step in the photocycle.
Die hohe Anzahl sportassoziierter Gehirnerschütterungen verdeutlicht die gesundheitliche Bedeutung dieser Verletzungen. Im Fußball liegt das Risiko bei 0,2 bis 1,4 Schädel-Hirnverletzungen pro 1.000 Spiel- und Trainingsstunden. Vor dem Hintergrund der Verletzungsprävention wird zwischen antizipierten und nicht-antizipierten Kraftstößen auf den Kopf unterschieden. Insbesondere jüngere und weibliche Spieler/innen können von einem spezifischen Training der Hals- und Rumpfmuskulatur zur Verletzungsprävention profitieren.
In komplexen Planungs- und Bauprojekten werden vermehrt die gesamten Planungsleistungen an Generalplaner übertragen. Den damit verbundenen Vorteilen steht für den Auftraggeber der Verlust an Informations-, Koordinations- und Steuerungsmöglichkeiten gegenüber. Vertraglich kann dieses Agenturproblem nicht vollständig und wasserdicht geregelt werden, es verbleiben immer Unsicherheiten. Vertrauensspezifische Regelungen in den Vertrag zu implementieren, kann als ergänzendes Steuerungsinstrument die Opportunismusneigung der Parteien reduzieren und das Agenturproblem besonders kostengünstig lösen. Vertrauen ist somit ein wesentlicher Erfolgsfaktor in der Kooperationsbeziehung von Bauherren und Generalplanern.
The idea of privileged scaffolds – that there seem to be more bioactive compounds found around some structures than others – is well established for small drug molecules, but has little significance for standalone peptide secondary structures whose adaptable shapes escape the definition of a 3D motif in the absence of a protein scaffold. Here, we joined two independent biological functions in a single highly restricted peptide to support the hypothesis that the β-hairpin shape is the common basis of two otherwise unrelated biological recognition processes. To achieve this, the hydrophobic cluster HWX4LV from the decapeptide cyclic hairpin model peptide C1-C10 cyclo-CHWEGNKLVC was included in the bicyclic peptide 2. The designed β-hairpin peptide C4-C17, C8-C13 bicyclo-KHQCHWECTZGRCRLVCGRSGS (2, Z = citrulline), serves, on the one hand, as a specific epitope for rheumatoid autoantibodies and, on the other hand, shows a not negligible antibiotic effect against the bacterial strain E. coli AS19.
Objective
The aim of the study was to investigate the effects of a 4-wk inpatient rehabilitation program on postural control and gait in pediatric patients with cancer.
Design
Eighty-eight patients with brain tumors (n = 59) and bone/soft tissue sarcomas (n = 29) were evaluated. Postural control was assessed examining the velocity of the center of pressure and single-leg stance time on a pressure distribution platform. Walk ratio, a measure of neuromotor control, was used to evaluate intervention effects on gait.
Results
Repeated measures analysis of variance showed improvements in postural control measures, indicated by a decrease in velocity of center of pressure of −0.4 cm/sec (F1,80 = 7.175, P = 0.009, ηp2 = 0.082) and increase in single-leg stance time (mean [median] = 1.1 [2.6] sec, respectively; F1,80 = 12.617, P = 0.001, ηp2 = 0.136). Walk ratio increased by 0.2 mm/steps per min (F1,82 = 3.766, P = 0.056, ηp2 = 0.044). Mean changes in dependent variables did not differ between both patient groups (P > 0.05).
Conclusions
The results indicate benefits of an inpatient rehabilitation program comprising standard physical therapy as well as aquatic and hippo therapy on postural control and gait after treatment of pediatric patients with cancer.