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Background. Ketone bodies are a highly relevant topic in nutrition and medicine. -e influence of medium-chain triglycerides (MCT) on ketogenesis is well known and has been successfully used in ketogenic diets for many years. Nevertheless, the effects of MCTs and coconut oil on the production of ketone bodies have only partially been investigated. Furthermore, the increased mobilisation of free fatty acids and release of catabolic hormones by caffeine suggest an influence of caffeine on ketogenesis.
Methods. In a controlled, double-blind intervention study, seven young healthy subjects received 10mL of tricaprylin (C8), tricaprin (C10), C8/C10 (50% C8, 50% C10), or coconut oil with or without 150 mg of caffeine, in 250mL of decaffeinated coffee, over ten interventions. At baseline and after every 40 minutes, for 4 h, ßHB and glucose in capillary blood as well as caffeine in saliva were measured. Furthermore, questionnaires were used to survey sensory properties, side effects, and awareness of hunger and satiety. Results. -e interventions with caffeine caused an increase in ßHB levels—in particular, the interventions with C8 highly impacted ketogenesis. -e effect decreased with increased chain lengths. All interventions showed a continuous increase in hunger and diminishing satiety. Mild side effects (total � 12) occurred during the interventions. Conclusions. -e present study demonstrated an influence of caffeine and MCTon ketogenesis. -eaddition of caffeine showed an additive effect on the ketogenic potential of MCT and coconut oil. C8 showed the highest ketogenicity.
Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users’ perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user’s point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information; while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients.
Background: Pediatric palliative care (PPC) is characterized by years of multisectoral and multi-professional care. Sharing information between PPC professionals is, therefore, essential for quality care. The evidence shows that electronic cross-facility health records (ECHRs) provide useful support in this context. To our knowledge, no ECHRs have been developed through a user-centered approach for this specific setting in Germany. Methods: Guided by design thinking, first, qualitative interviews were conducted to assess the needs of PPC professionals. Second, the elicited needs were specified in focus groups (FGs). Based on the needs stated in the interviews, prototypes of the ECHR were developed and discussed in the FGs. The indicated needs were supplemented and specified in an iterative process. The prototypes were further adapted according to these results. The unified theory of acceptance and use of technology was the basic model in the evaluation of needs. Results: Across seven main categories, past and current medication, emergency view, and messaging functions were identified as the participants’ desired core components of an ECHR. Utilizing design thinking facilitated the explicit articulation of user needs. Conclusions: Developing an ECHR with the content identified would allow for real-time data during emergencies, tracking what other PPC professionals have done, and making the applied treatments visible to others. This would offer a broader picture of the complex conditions common to PPC.
Steigerung der Versorgungsqualität in der Palliativversorgung durch elektronische Gesundheitsakten
(2021)
BACKGROUND Interest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary. OBJECTIVE In addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care. METHODS In February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis. RESULTS The majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients. CONCLUSIONS The literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future.
(1) Background: Schools report a high number of schoolchildren with poor attention and hyperactive behavior, with 5% being diagnosed with attention deficit/hyperactivity disorder (ADHD). This causes specific problems during homework and classroom times, and the extension of all-day schooling in German primary schools makes this a challenge for support staff working in the after-school programs. Such staff have a very wide variety of qualifications, ranging from no formal teacher training to full teaching qualifications. (2) Methods: This study documents the knowledge of 196 support staff working in all-day primary schools about ADHD, and their subjective view of whether they feel competent with regard to homework situations in general and ADHD in particular. (3) Results: Those with an educational background have significantly more knowledge than those without such a background, staff feel less prepared to supervise children with ADHD, and there is a small but significant correlation here with knowledge about ADHD. (4) Conclusions: The importance of trained pedagogical staff in the supervision of children with concentration problems is emphasized.
This paper presents a seminar concept for the development of communication competence in pre-service vocational education teachers with the aid of video annotations, feedback, and peer microteaching. The seminar is offered within a teacher training program for students taking a master’s degree (MEd) in vocational education at the FH Münster University of Applied Sciences, Germany, and has been conducted three times. The advantages of the seminar concept are manifold. On the one hand, we create a learning environment in which students individually prepare and conduct five peer microteaching lessons in a row and receive prompt and constructive peer feedback on every performance. On the other hand, the quality of feedback improves so that our students are professional feedback providers by the end of the seminar. The provision of teacher feedback alone does not help our students become successful feedback providers. Nor, given the resources available at the university, is it a realistic alternative in terms of time constraints. In addition, due to recordings, the students gain a better insight into their teaching skills since their lessons can be observed and approached from an outside perspective.
Experimental results are presented of a test of the theory of local turbulent heat transfer measurements proposed by Mocikat and Herwig in 2007. A miniaturized multi-layer heat transfer sensor was developed and employed in this study. The new heat transfer sensor was designed to work in air and liquids, and this capability enabled the simultaneous investigation of different Prandtl numbers. Two basic configurations, namely the flow past a blunt plate and the flow past an inclined square cylinder, were investigated in test sections of wind and water tunnels. Convective heat transfer coefficients were obtained through conventional testing (i.e., employing thoroughly heated test objects) and using the new miniaturized sensor approach (i.e., utilizing cold test objects without heating). The main prediction of the Mocikat-Herwig theory that a specific thermal adjustment coefficient of the employed actual miniaturized heat transfer sensor should exist in the fully turbulent flow regime was proven for developed two-dimensional flow. The observed effect of the Prandtl number on this coefficient was in good agreement with the prediction of the asymptotic expansion method. The square cylinder results indicated the inherent limits of the local turbulent heat transfer measurement approach, as suggested by Mocikat and Herwig.
Adhärenz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen
(2021)
AbstractMany digital interventions rely on the participation of their users to have a positive impact. In various areas it can be observed that the use of digital interventions is often reduced or fully discontinued by the users after a short period of time. This is seen as one of the main factors that can limit the effectiveness of digital interventions. In this context, the concept of adherence to digital interventions is becoming increasingly important. Adherence to digital interventions is roughly defined as “the degree to which the user followed the program as it was designed,” which can also be paraphrased as “intended use” or “use as it is designed.” However, both the theoretical–conceptual and practical discussions regarding adherence to digital interventions still receive too little attention.The aim of this narrative review article is to shed more light on the concept of adherence to digital interventions and to distinguish it from related concepts. It also discusses the methods and metrics that can be used to operationalize adherence and the predictors that positively influence adherence. Finally, needs for action to better address adherence are considered critically.