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Expectations of new technologies in nursing care among hospital patients in Germany: an interview study
Get PDFIntroduction New technologies will be increasingly available for nursing care, including robots, patient mobilisation devices, digital event detection or prevention equipment. Technologies are expected to support nurses, increase patients' safety and reduce costs. Yet, although these technologies will significantly shape patients' experience, we need to learn more about patients' perspectives regarding new technology in care. This study aims to investigate attitudes, expectations, worries and anticipated implementation effects of new assistive technology in nursing care by patients. Methods Qualitative, guided, semi-open interviews were conducted. The recruitment was carried out in a trauma surgery ward of a university hospital in Germany. Eight different technologies were presented via video clips and additional information to the patients, followed by in-depth discussions. The interviews were analysed using qualitative evaluative content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) Checklist was used to ensure study quality. Results Study participants anticipate different outcomes for the implementation of new nursing technology: (1) For patients, they consider the potential for improvement in health and well-being as well as for their hospital stay experience, but also fear possible health risks or social or emotional factors like loss of autonomy or loneliness. (2) For professional nurses, participants expect relief from physically stressful work routines; however, they might be replaced by machines and lose their employment (3) For the nursing process, safety and quality improvements for care delivery may encounter a negative quantification of human life and risks of constant surveillance. Conclusion Patients identify opportunities, challenges and shortcomings of nursing technology implementation. They describe nuanced and mixed accounts of patients' perspectives that are structured in a 'continuum of anticipated effects' of implementing technology in our article. The results can inform future implementation strategies
p38MAPK/MK2 signaling stimulates host cells autophagy pathways to restrict Salmonella infection.
Get PDFAutophagy plays an important role in recognizing and protecting cells from invading intracellular pathogens such as Salmonella. In this work, we investigated the role of p38MAPK/MK2 in modulating the host cell susceptibility to Salmonella infection. Inhibition of p38MAPK or MK2 led to a significant increase of bacterial counts in Salmonella infected mouse embryonic fibroblasts (MEFs), as well as in MK2-deficient (Mk2-/-) cells. Furthermore, western blot analysis showed that Mk2-/- cells have lower level of LC3 lipidation, which is the indicator of general autophagy compared to Mk2-rescued cells. In Mk2-/- cells, we also observed lower activated TANK-binding kinase-1 phosphorylation on Ser172 and p62/SQTM1-Ser403 phosphorylation, which are important to promote the translocation of p62 to ubiquitinated microbes and required for efficient autophagy of bacteria. Furthermore, immunofluorescence analysis revealed reduced colocalization of Salmonella with LC3 and p62 in MEFs. Inhibition of autophagy with bafilomycin A1 showed increased bacterial counts in treated cells compared to control cell. Overall, these results indicate that p38MAPK/MK2-mediated protein phosphorylation modulates the host cell susceptibility to Salmonella infection by affecting the autophagy pathways
Analyse von Routine-Laborparametern in Patienten mit Amyotropher Lateralsklerose in Hinblick auf ihr Potential als Biomarker für den Krankheitsverlauf: eine multizentrische Studie
Get PDFNutzen und Grenzen von transjugulären intrahepatischen portosystemischen Shunts (TIPS) bei Patienten mit dekompensierter Leberzirrhose
Get PDFThe aging kidney is characterized by tubuloinflammaging, a phenotype associated with MHC-II gene expression
Get PDFIntroduction Even during physiologic aging, the kidney experiences a loss of mass and a progressive functional decline. This is clinically relevant as it leads to an increased risk of acute and chronic kidney disease. The kidney tubular system plays an important role in the underlying aging process, but the involved cellular mechanisms remain largely elusive. Methods Kidneys of 3-, 12- and 24-month-old male C57BL/6J mice were used for RNA sequencing, histological examination, immunostaining and RNA-in-situ-hybridization. Single cell RNA sequencing data of differentially aged murine and human kidneys was analyzed to identify age-dependent expression patterns in tubular epithelial cells. Senescent and non-senescent primary tubular epithelial cells from mouse kidney were used for in vitro experiments. Results During normal kidney aging, tubular cells adopt an inflammatory phenotype, characterized by the expression of MHC class II related genes. In our analysis of bulk and single cell transcriptional data we found that subsets of tubular cells show an age-related expression of Cd74, H2-Eb1 and H2-Ab1 in mice and CD74, HLA-DQB1 and HLADRB1 in humans. Expression of MHC class II related genes was associated with a phenotype of tubular cell senescence, and the selective elimination of senescent cells reversed the phenotype. Exposure to the Cd74 ligand MIF promoted a prosenescent phenotype in tubular cell cultures. Discussion Together, these data suggest that during normal renal aging tubular cells activate a program of 'tubuloinflammaging', which might contribute to age-related phenotypical changes and to increased disease susceptibility
Passage- and Serum- dependent changes of adipose- derived stromal cells in vitro
Get PDFPassage- and Serum- dependent changes of adipose- derived stromal cells in vitro: a discrepancy of stemness factors regarding mesenchymal surface markers and expression of stemness related genes. Erhebung der Daten erfolgte durch Renata Sonnenfeld im Kerstin Reimers Labor (ehemals Labor für Regenerationsbiologie) der Klinik für Plastische, Ästhetische, Hand- & Wiederherstellungschirurgie der Medizinischen Hochschule Hannover. Methoden und Geräte: FACS, PCR, Mikroskopie. Literatur und Quellen siehe Referenzliste im pdf
Die Rolle von humanen Monozytensubtypen und der CX3CR1-CX3CL1 Interaktion in der Regulation des Endothelphänotyps bei chronischer Niereninsuffizienz
Get PDFAnpassung - Widerstand? Anmerkungen zur sozialpsychiatrischen Haltung im Angesicht der Digitalisierung
Get PDFA computational model to simulate spectral modulation and speech perception experiments of cochlear implant users
Get PDFSpeech understanding in cochlear implant (CI) users presents large intersubject variability that may be related to different aspects of the peripheral auditory system, such as the electrode-nerve interface and neural health conditions. This variability makes it more challenging to proof differences in performance between different CI sound coding strategies in regular clinical studies, nevertheless, computational models can be helpful to assess the speech performance of CI users in an environment where all these physiological aspects can be controlled. In this study, differences in performance between three variants of the HiRes Fidelity 120 (F120) sound coding strategy are studied with a computational model. The computational model consists of (i) a processing stage with the sound coding strategy, (ii) a three-dimensional electrode-nerve interface that accounts for auditory nerve fiber (ANF) degeneration, (iii) a population of phenomenological ANF models, and (iv) a feature extractor algorithm to obtain the internal representation (IR) of the neural activity. As the back-end, the simulation framework for auditory discrimination experiments (FADE) was chosen. Two experiments relevant to speech understanding were performed: one related to spectral modulation threshold (SMT), and the other one related to speech reception threshold (SRT). These experiments included three different neural health conditions (healthy ANFs, and moderate and severe ANF degeneration). The F120 was configured to use sequential stimulation (F120-S), and simultaneous stimulation with two (F120-P) and three (F120-T) simultaneously active channels. Simultaneous stimulation causes electric interaction that smears the spectrotemporal information transmitted to the ANFs, and it has been hypothesized to lead to even worse information transmission in poor neural health conditions. In general, worse neural health conditions led to worse predicted performance; nevertheless, the detriment was small compared to clinical data. Results in SRT experiments indicated that performance with simultaneous stimulation, especially F120-T, were more affected by neural degeneration than with sequential stimulation. Results in SMT experiments showed no significant difference in performance. Although the proposed model in its current state is able to perform SMT and SRT experiments, it is not reliable to predict real CI users' performance yet. Nevertheless, improvements related to the ANF model, feature extraction, and predictor algorithm are discussed
Measuring disrespect and abuse during childbirth in a high-resource country: Development and validation of a German self-report tool.
Get PDFIntroduction Increasing evidence on disrespect and abuse during childbirth has led to growing concern about the quality of care childbearing women are experiencing. To provide quantitative evidence of disrespect and abuse during childbirth services in Germany a validated measurement tool is needed. Research aim The aim of this research project was the development and psychometric validation of a survey tool in the German language that measures disrespect and abuse of women during childbirth. Methods A survey tool was created including the following measures: German adaptations of the short and long form of the "Mothers on Respect" (MOR) index (MOR-7 and MOR-G); the "Mothers' Autonomy in Decision Making" (MADM) scale; a mistreatment-index (MIST-I) comprising indicators of mistreatment during childbirth; and a set of items that measure experiences of discrimination during maternity care. Internal consistency reliability and construct validity of the scales were assessed using Cronbach's alpha, unweighted least squares factor analysis and non-parametric correlation analysis with a scale that measures a related construct, the Posttraumatic Symptom Scale - Self Report (PSS-SR) scale. We distributed the survey online, recruiting through snowball sampling via social media. A selection bias towards women who had experienced disrespect and abuse during their birth was intended and expedient for tool validation. The final sample of participants (n = 2045) had given birth in Germany between 2009 and 2018. Findings More than 77% of the study participants reported at least one form of mistreatment with non-consented care being the most commonly reported type of mistreatment, followed by physical violence, violation of physical privacy, verbal abuse and neglect. All included scales showed good psychometric properties with high Cronbach's alphas (0.95 for both MOR versions and 0.96 for MADM). Factor analysis generated one factor scales with high factor loadings (0.75 to 0.92 for MOR-7; 0.37 to 0.90 for MOR-G and 0.83 to 0.92 for MADM). MOR-7, MOR-G, MADM and MIST-I scores were significantly (p<0.001) correlated with PSS-SR scores (Spearman's rho -0.70, -0.61 and 0.68 for MOR-G, MADM and the MIST-I, respectively). Conclusions This study presents a valid and reliable instrument for the quantitative assessment of disrespect and abuse during childbirth in Germany. Childbearing women's experiences of disrespect and abuse are a relevant phenomenon in German hospital based maternity care. Disrespect and abuse during childbirth appear to contribute to post-traumatic symptoms and may be associated with severe mental health problems postpartum