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Leben und Lernen hinter dem Eisernen Vorhang: Studierende aus Subsahara-Afrika in der Sowjetunion
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Schizophrenien und andere psychotische Störungen in der ICD-11
No full textDas Kapitel „Schizophrenie oder andere primäre psychotische Störungen“ erfährt in der 11. Revision der International Classification of Diseases (ICD-11) einige umfassende Revisionen. Es nähert sich damit der 5. Edition des Diagnostischen und Statistischen Manuals Psychischer Störungen (DSM-5) an. Der Beitrag zeigt die Änderungen und die Konsequenzen für den klinischen Alltag auf
Audio-biofeedback versus the scale method for improving partial weight-bearing adherence in healthy older adults: a randomised trial.
Get PDFPURPOSE
To investigate how audio-biofeedback during the instruction of partial weight-bearing affected adherence, compared to traditional methods, in older adults; and to investigate the influence of individual characteristics.
METHODS
The primary outcome measure of this randomised controlled trial was the amount of load, measured as the ground reaction force, on the partial weight-bearing leg. The secondary outcome was the influence of individual characteristics on the amount of load. Included were healthy volunteers 60 years of age or older without gait impairment. Participants were randomly allocated to one of two groups; blinding was not possible. Partial weight-bearing of 20 kg was trained using crutches with audio-biofeedback (intervention group) or a bathroom scale (control group). The degree of weight-bearing was measured during six activities with sensor insoles. A mean load between 15 and 25 kg was defined as adherent.
RESULTS
There was no statistically significant difference in weight-bearing between the groups for all activities measured. For the sit-stand-sit activity, weight-bearing was within the adherence range of 15-25 kg (audio-biofeedback: 21.7 ± 16.6 kg; scale: 22.6 ± 13 kg). For standing, loading was below the lower threshold (10 ± 7 vs. 10 ± 10 kg). Weight-bearing was above the upper threshold for both groups for: walking (26 ± 11 vs. 34 ± 16), step-up (29 ± 18 vs. 34 ± 20 kg) and step-down (28 ± 15 vs. 35 ± 19 kg). Lower level of cognitive function, older age, and higher body mass index were correlated with overloading.
CONCLUSION
Audio-biofeedback delivered no statistically significant benefit over the scale method. Lower cognitive function, older age and higher body mass index were associated with overloading.
TRIAL REGISTRATION
Not applicable due not being a clinical trial and due to the cross-sectional design (one measurement point, no health intervention, no change in health of a person)
Digital Learning in Swiss Medical Education: A Nationwide Survey of Student Perceptions
No full textBackground: The integration of Digital Learning and Teaching (DLT) in medical education has critically impacted student learning while offering flexibility and diverse opportunities. This study aims to explore Swiss medical students’ perceptions of DLT, examining its benefits, challenges, and implications for future curriculum development.
Methods: A cross-sectional survey study involving N=470 medical students from eight Swiss medical schools was conducted. The survey assessed students’ views on DLT, including their self-efficacy with technology, opinions on online assessments, study habits, and affective responses to the transition to online learning.
Results: The majority of participants were female, averaging 22 years of age. Notably, male students reported higher computer literacy. Students from smaller schools reported more positive DLT experiences and fewer study hours compared to those from larger institutions. Overall, the students reported high confidence in their DLT skills while recognizing the importance of online resources, concerns were raised about online assessments and the lack of face-to-face interaction. Students also often perceived the teachers as inadequately prepared for DLT. The extended use of DLT also revealed potential emotional stressors, such as feelings of isolation. Students advocated for improved instructor proficiency in DLT and better support systems for technical issues.
Discussion and conclusion: The study reveals a dichotomy in students’ experiences with DLT, balancing the convenience and empowerment of digital tools against technical challenges and psychological effects of reduced in-person engagement. These findings highlight the necessity for a balanced DLT approach, tech-savvy educators, and strong support systems to optimize educational outcomes and student well-being. The research emphasizes the significance of DLT in modernizing medical education while acknowledging the complexities of its implementation. As medical education evolves, adaptive strategies that cater to both technological and human aspects of learning are crucial
Autistic Adults Avoid Unpredictability in Decision-Making.
Get PDFDecision-making under unpredictable conditions can cause discomfort in autistic persons due to their preference for predictability. Decision-making impairments might furthermore be associated with a dysregulation of sex and stress hormones. This prospective, cross-sectional study investigated decision-making in 32 autistic participants (AP, 14 female) and 31 non-autistic participants (NAP, 20 female) aged 18-64 years. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under ambiguity and under risk with known outcome probabilities, respectively. Cortisol, estradiol, and testosterone serum levels were related to decision-making performance. Groups did not differ in overall IGT and CRT performance, but compared with NAP, AP preferred less profitable card decks with predictable outcomes while avoiding those with unpredictable outcomes. AP required more time to reach decisions compared to NAP. Additionally, AP without comorbid depression performed significantly worse than NAP in the IGT. Estradiol and cortisol concentrations were significant predictors of CRT scores in NAP, but not in AP. The study results imply that AP are 'risk-averse' in decision-making under ambiguity as they avoided choice options with unpredictable losses in comparison to NAP. Our findings highlight the intolerance for uncertainty, particularly in ambiguous situations. Thus, we recommend being as transparent and precise as possible when interacting with autistic individuals. Future research should explore decision-making in social situations among individuals with ASD, factoring in person-dependent variables such as depression
Immune-mediated thrombotic thrombocytopenic purpura with ischaemic cerebral infarction preceding onset of thrombocytopenia and microangiopathic haemolytic anaemia: A case report.
No full textDisproportionality Analysis From World Health Organization Data on Semaglutide, Liraglutide, and Suicidality.
Get PDFIMPORTANCE
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have gained use primarily due to their weight-reduction effects, although a regulatory review was undertaken for potential suicidality concern.
OBJECTIVES
To evaluate potential signals for suicidal and self-injurious adverse drug reactions (ADRs) associated with the GLP-1 RAs semaglutide and liraglutide.
DESIGN, SETTING, AND PARTICIPANTS
Disproportionality analysis through the case-control design using the World Health Organization (WHO) global database of suspected ADRs. Participants were clinical patients worldwide experiencing an ADR suspectedly attributable to semaglutide or liraglutide in the database from inception to August 30, 2023. Data were analyzed from September to December 2023.
EXPOSURE
Treatment with semaglutide or liraglutide regardless of indication or treatment duration.
MAIN OUTCOMES AND MEASURES
Reporting odds ratio (ROR) and the bayesian information component (IC) with 95% CIs were calculated as measures of disproportionate reporting of suicidal and self-injurious ADRs associated with semaglutide and liraglutide compared with all other medications. Sensitivity analyses were conducted including patients with coreported use of antidepressants and benzodiazepines and using dapagliflozin, metformin, and orlistat as comparators. A disproportionality signal was considered when the lower limits of the ROR and IC were above 1 and 0, respectively.
RESULTS
A total of 107 (median [IQR] age 48 [40-56] years; 59 female patients [55%]) and 162 (median [IQR] age 47 [38-60] years; 100 female patients [61%]) cases of suicidal and/or self-injurious ADRs were reported between November 2000 and August 2023 with semaglutide and liraglutide, respectively. Significant disproportionality was detected only for semaglutide-associated suicidal ideation (ROR, 1.45; 95% CI, 1.18-1.77; IC, 0.53; 95% CI, 0.19-0.78), which remained significant in patients with coreported use of antidepressants (ROR, 4.45; 95% CI, 2.52-7.86; IC, 1.96; 95% CI, 0.98-2.63) and benzodiazepines (ROR, 4.07; 95% CI, 1.69-9.82; IC, 1.67; 95% CI, 0.11-2.65), when compared with dapagliflozin (ROR, 5.56; 95% CI, 3.23-9.60; IC, 0.70; 95% CI, 0.36-0.95), metformin (ROR, 3.86; 95% CI, 2.91-5.12; IC, 1.20; 95% CI, 0.94-1.53) and orlistat (ROR, 4.24; 95% CI, 2.69-6.69; IC, 0.70; 95% CI, 0.36-0.95).
CONCLUSIONS AND RELEVANCE
This study using the WHO database found a signal of semaglutide-associated suicidal ideation, which warrants urgent clarification
Raw trace element data obtained by LA-ICP-MS for analysed tephra across 751-763 CE from B19 and TUNU2013 ice cores (Greenland)
No full textRaw Trace element data of analysed ice core samples from B19 [78.00°N/36.40°W] and TUNU2013 [78.04°N/33.88°W] ice cores (Greenland) across the period 751-763 CE. Trace element data was obtained by LA-ICP-MS at the University of St Andrews, UK using a beam diameter of 20µm, laser energy of 3.5 J cm-2 (4 Hz repetition rate), 30-s ablation time and 20-s background measurement
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