The Post COVID-19 condition (PCC) is a complex disease affecting health and everyday functioning. This is well reflected by a patient's inability to work (ITW). In this study, we aimed to investigate factors associated with ITW (1) and to design a machine learning-based model for predicting ITW (2) twelve months after baseline.
View Article and Find Full Text PDFInt J Qual Health Care
January 2025
Background: Healthcare systems worldwide experience shortages of healthcare professionals. Retention of physicians is becoming an increasing problem. The psychological safety among physicians affects not only performance, but also their emotional well-being and job satisfaction.
View Article and Find Full Text PDFPurpose: In order to obtain sustainable healthcare, engagement of patients in patient safety improvement is vital. Drawing upon a multi-perspective approach, this study aimed to investigate perspectives of patients and healthcare professionals on key implementation factors (ie, barriers and facilitators) for effective patient engagement (PE) in healthcare organizations to improve patient safety.
Patients And Methods: A two-round Delphi technique comprising semi-structured interviews and an online survey was applied to consolidate the individual perspectives of stakeholders and establish consensus on factors (expected, potential or experienced) that facilitate or mitigate successful implementation of PE in healthcare organizations (ie, all types, including hospital and outpatient medical practices).
Focal gene amplifications are among the most common cancer-associated mutations but have proven challenging to engineer in primary cells and model organisms. Here we describe a general strategy to engineer large (more than 1 Mbp) focal amplifications mediated by extrachromosomal DNAs (ecDNAs) in a spatiotemporally controlled manner in cells and in mice. By coupling ecDNA formation with expression of selectable markers, we track the dynamics of ecDNA-containing cells under physiological conditions and in the presence of specific selective pressures.
View Article and Find Full Text PDFBundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
December 2024
In German-speaking countries, early childhood intervention programmes-known as "Frühe Hilfen"-are generally understood as an overall concept of health promotion measures that particularly target early intervention in pregnancy and early childhood and are primarily aimed at families in stressful life situations. This article provides an overview of early intervention services in Germany, Austria, Switzerland, Liechtenstein and South Tyrol.While various models have been implemented in Germany and continue to co-exist to this day, a standardised model has been established in Austria.
View Article and Find Full Text PDFBackground: Patients transitioning between different care contexts are at increased risk of experiencing adverse events. In particular, being discharged to home after inpatient treatment involves significant risks. However, there is a lack of valid and internationally comparable assessment tools on patients' experiences of difficulties following hospital discharge.
View Article and Find Full Text PDFIn healthcare, integration of artificial intelligence (AI) holds strong promise for facilitating clinicians' work, especially in clinical imaging. We aimed to assess the impact of AI implementation for medical imaging on efficiency in real-world clinical workflows and conducted a systematic review searching six medical databases. Two reviewers double-screened all records.
View Article and Find Full Text PDFObjective: Evidence of geographical variation in total hip replacement (THR) and deviations from treatment guidelines persists. In this exploratory study, we aim to gain an in-depth understanding of patients' healthcare trajectories by identifying and visualising medication use patterns in coxarthrosis patients before surgery. We examine their association with patient characteristics and THR, and compare them with recommendations on mild analgesics, opioid prescription and exhaustion of conservative therapy.
View Article and Find Full Text PDFBackground And Objectives: Despite increasing calls for more patient engagement in patient safety, limited knowledge remains on what actually motivates key stakeholders in healthcare to promote patient engagement. We therefore set out to survey key stakeholders of patient engagement in patient safety (i.e.
View Article and Find Full Text PDFPurpose: This study aimed to compare the outcomes of robotic-assisted rectal resection with conventional laparoscopic and open approaches, focusing on complication rates, conversion rates, length of hospital stay, and oncologic outcomes.
Methods: A retrospective single-center cohort study included 106 patients with non-metastatic rectal cancer (UICC stages I-III) who underwent rectal resection from January 2013 to December 2023. Patients were assigned to open surgery (n = 23), conventional laparoscopic surgery (n = 55), or robotic-assisted surgery (n = 28).
Background: Transitions of care after cancer treatment pose a major challenge for patient safety as adverse events and unplanned healthcare utilization occur frequently. At this point, patient and family engagement (PFE) is particularly valuable since patients and their families experience various challenges along this pathway, such as changing roles and recurrent needs to navigate across structural gaps between different services. However, there is currently a lack of evidence on the impact of PFE on patient safety in transitions after cancer treatment.
View Article and Find Full Text PDFRobot-assisted surgery (RAS) differs from traditional OR set-ups in several ways such as operation of technology and obstructed team communication that potentially affect surgical staff's stress experiences. The current study investigates the effects of key intraoperative job demands and resources on mental workload and perceived stress in RAS. We focused on the role of intraoperative teamwork as a resource that potentially reduces occupational stress.
View Article and Find Full Text PDFBackground: Recent analyses have shown that in health services research in Germany, healthcare organisations are often considered primarily as a study setting, without fully taking their complex organisational nature into account, neither theoretically nor methodologically. Therefore, an initiative was launched to analyse the state of Organisational Health Services Research (OHSR) in Germany and to develop a strategic framework and road map to guide future efforts in the field. This paper summarizes positions that have been jointly developed by consulting experts from the interdisciplinary and international scientific community.
View Article and Find Full Text PDFBackground And Importance: Modern emergency medicine (EM) is a complex, demanding, and occasionally stressful field of work. Working conditions, provider well-being, and associated health and performance outcomes are key factors influencing the establishment of a sustainable emergency department (ED) working environment.
Objectives: This multinational European Delphi survey aimed to identify unequivocal major factors for good and poor ED working conditions and their possible effects on health care provider well-being.
Extracellular vesicles (EVs) are crucial mediators of cell-to-cell communication in physiological and pathological conditions. Specifically, EVs released from the vasculature into blood were found to be quantitatively and qualitatively different in diseases compared to healthy states. However, our understanding of EVs derived from the lymphatic system is still scarce.
View Article and Find Full Text PDFZ Evid Fortbild Qual Gesundhwes
June 2024
Clinical Risk Management (CRM) is an important instrument to continuously improve safety of health care delivery. In Germany, hospitals are required by law to implement CRM and incidence reporting systems. Since 2010, nation-wide surveys have been conducted periodically to evaluate implementation of CRM in hospitals.
View Article and Find Full Text PDFIn the last decade cellular senescence, a hallmark of aging, has come into focus for pharmacologically targeting aging processes. Senolytics are one of these interventive strategies that have advanced into clinical trials, creating an unmet need for minimally invasive biomarkers of senescent cell load to identify patients at need for senotherapy. We created a landscape of miRNA and mRNA expression in five human cell types induced to senescence and provide proof-of-principle evidence that miRNA expression can track senescence burden dynamically using transgenic p21 senescent cell clearance in HFD fed mice.
View Article and Find Full Text PDFPurpose: The objective examination of the Post-COVID syndrome (PCS) remains difficult due to heterogeneous definitions and clinical phenotypes. The aim of the study was to verify the functionality and correlates of a recently developed PCS score.
Methods: The PCS score was applied to the prospective, multi-center cross-sectoral cohort (in- and outpatients with SARS-CoV-2 infection) of the "National Pandemic Cohort Network (NAPKON, Germany)".
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
May 2024
Background: Transitions from inpatient care are associated with risks for the safety of patients. In 2017, the framework agreement on discharge management was legally defined. There is currently a lack of empirical data in Germany on the implementation of measures to ensure safe transitions of patients after inpatient care.
View Article and Find Full Text PDFBackground: Working conditions in the age of digitalization harbor risks for chronic stress and burnout. However, real-world investigations into biological effects of technostress, that is stress in the context of digital technology use, are sparse. This study prospectively assessed associations between technostress, general work stress, burnout symptoms, hair cortisol, and chronic low-grade inflammation.
View Article and Find Full Text PDFIn healthcare, artificial intelligence (AI) is expected to improve work processes, yet most research focuses on the technical features of AI rather than its real-world clinical implementation. To evaluate the implementation process of an AI-based computer-aided detection system (AI-CAD) for prostate MRI readings, we interviewed German radiologists in a pre-post design. We embedded our findings in the Model of Workflow Integration and the Technology Acceptance Model to analyze workflow effects, facilitators, and barriers.
View Article and Find Full Text PDFEur Arch Psychiatry Clin Neurosci
December 2024
There is a lack of interventions that treat the Post-Covid-19 Condition (PCC) itself. Accordingly, treatment guidelines recommend physiotherapy interventions to alleviate symptoms and enhance functioning. In cases where unimodal treatments prove ineffective, non-organ-specific multidisciplinary bio-psycho-social rehabilitation (MBR) programs are a suitable option.
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