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Article ; Online: A new approach to making scientific research more efficient - rethinking sustainability.

Penndorf, Patrick / Jabs, Johannes

2023 Volume 597, Issue 19, Page(s) 2371–2374

Abstract: As interest in sustainability grows, many researchers raise questions about changing scientific practices. To enable effective change, we reconceptualize sustainability as an approach that optimizes the efficiency of procedures, thereby benefiting ... ...

Abstract	As interest in sustainability grows, many researchers raise questions about changing scientific practices. To enable effective change, we reconceptualize sustainability as an approach that optimizes the efficiency of procedures, thereby benefiting scientists and minimizing environmental footprints. Since the implementation of sustainable approaches can be challenging, we describe the 6R concept as a framework to arrive at actionable steps.
Language	English
Publishing date	2023-09-22
Publishing country	England
Document type	Editorial
ZDB-ID	212746-5
ISSN	1873-3468 ; 0014-5793
ISSN (online)	1873-3468
ISSN	0014-5793
DOI	10.1002/1873-3468.14736
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Article ; Online: A low-threshold intervention to increase physical activity and reduce physical inactivity in a group of healthy elderly people in Germany: Results of the randomized controlled MOVING study.

Kleinke, Fabian / Ulbricht, Sabina / Dörr, Marcus / Penndorf, Peter / Hoffmann, Wolfgang / van den Berg, Neeltje

PloS one

2021 Volume 16, Issue 9, Page(s) e0257326

Abstract: Background: Lack of physical activity (PA) and a high level of physical inactivity (PI) are associated with a higher risk for mortality and responsible for several non-communicable diseases including cardiovascular disease. Higher age is associated with ...

Abstract	Background: Lack of physical activity (PA) and a high level of physical inactivity (PI) are associated with a higher risk for mortality and responsible for several non-communicable diseases including cardiovascular disease. Higher age is associated with a decrease of PA and an increasing level of PI. Studies have shown that interventions in the elderly have the potential to increase the amount of PA and to decrease the level of PI. However, most interventions are complex, elaborated, time- and resource-consuming. Here, we examined the effect of individual feedback-letters reporting the measured PA and PI in a sample of elderly people in Germany. Primary outcomes of the study were overall PA and PI after 6 months in the intervention group compared to a control group. Methods: We examined data from the MOVING intervention study (RCT) for people aged ≥ 65 years living in the northeast of Germany. At baseline, 3 and 6-months follow-up, all study participants wore a 3-axis accelerometer over a period of seven consecutive days. After the baseline measurement, the participants were randomized into intervention and control group. Participants in the intervention group received automatically generated, individualized feedback letters reporting their PA and PI by mail after the baseline measurement and after the 3-months follow-up. A Two-Way Mixed ANOVA with repeated measures was calculated with light, moderate and overall PA as well as PI as dependent variables, and group (between subject) and time (inner subject) as factors. The analysis based on retrospective data from the MOVING study (2016-2018). Results: N = 258 patients were recruited. N = 166 participants could be included in the analysis, thereof N = 97 women (58.4%). The mean age was 70.8 years (SD 4.8). At baseline, the participants had a mean wearing time of 5,934.5 minutes (SD = 789.5) per week, which corresponds to about 14 hours daily on average. The overall PA in the intervention group at the 6-months follow up was 2488.8 (95% CI 2358.9-2618.2) minutes and 2408.2 (95% CI 2263.0-2553.4) minutes in the control group. There was no statistically significant interaction effect (timegroup) between the intervention and control group for the depending variables. Sensitivity analyses showed significant small positive effects of the interaction timepartnership, F(2, 300) = 3.020, p = 0.05, partial η2 = 0.020. Discussion: On average, study participants had high levels of PA at baseline and showed a good adherence in wearing the accelerometer. Both is likely due to selection in the convenience study sample. Thus, some ceiling effect reduced the overall intervention effect somewhat. At baseline, the weekly average of PI was 3436.7 minutes, which correspondents to about 8.2 hours per day and about 57% of participants' daily waking time. The average level of PI could be slightly decreased in both study groups. Trial registration number: DRKS00010410, 17 May 2017.
MeSH term(s)	Accelerometry ; Aged ; Aged, 80 and over ; Exercise ; Feedback ; Female ; Germany/epidemiology ; Health Promotion/methods ; Health Services for the Aged/organization & administration ; Health Status ; Humans ; Male ; Program Development ; Retrospective Studies ; Sedentary Behavior ; Treatment Outcome
Language	English
Publishing date	2021-09-16
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0257326
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Article ; Online: Triage through telemedicine in paediatric emergency care-Results of a concordance study.

Beyer, Angelika / Moon, Kilson / Penndorf, Peter / Hirsch, Thomas / Zahn-Tesch, Uta / Hoffmann, Wolfgang / Lode, Holger N / van den Berg, Neeltje

PloS one

2022 Volume 17, Issue 5, Page(s) e0269058

Abstract: Background: In the German health care system, parents with an acutely ill child can visit an emergency room (ER) 24 hours a day, seven days a week. At the ER, the patient receives a medical consultation. Many parents use these facilities as they do not ... ...

Abstract	Background: In the German health care system, parents with an acutely ill child can visit an emergency room (ER) 24 hours a day, seven days a week. At the ER, the patient receives a medical consultation. Many parents use these facilities as they do not know how urgently their child requires medical attention. In recent years, paediatric departments in smaller hospitals have been closed, particularly in rural regions. As a result of this, the distances that patients must travel to paediatric care facilities in these regions are increasing, causing more children to visit an ER for adults. However, paediatric expertise is often required in order to assess how quickly the patient requires treatment and select an adequate treatment. This decision is made by a doctor in German ERs. We have examined whether remote paediatricians can perform a standardised urgency assessment (triage) using a video conferencing system. Methods: Only acutely ill patients who were brought to a paediatric emergency room (paedER) by their parents or carers, without prior medical consultation, have been included in this study. First, an on-site paediatrician assessed the urgency of each case using a standardised triage. In order to do this, the Paediatric Canadian Triage and Acuity Scale (PaedCTAS) was translated into German and adapted for use in a standardised IT-based data collection tool. After the initial on-site triage, a telemedicine paediatrician, based in a different hospital, repeated the triage using a video conferencing system. Both paediatricians used the same triage procedure. The primary outcome was the degree of concordance and interobserver agreement, measured using Cohen's kappa, between the two paediatricians. We have also included patient and assessor demographics. Results: A total of 266 patients were included in the study. Of these, 227 cases were eligible for the concordance analysis. In n = 154 cases (68%), there was concordance between the on-site paediatrician's and telemedicine paediatrician's urgency assessments. In n = 50 cases (22%), the telemedicine paediatrician rated the urgency of the patient's condition higher (overtriage); in 23 cases (10%), the assessment indicated a lower urgency (undertriage). Nineteen medical doctors were included in the study, mostly trained paediatric specialists. Some of them acted as an on-site doctor and telemedicine doctor. Cohen's weighted kappa was 0.64 (95% CI: 0.49-0.79), indicating a substantial agreement between the specialists. Conclusions: Telemedical triage can assist in providing acute paediatric care in regions with a low density of paediatric care facilities. The next steps are further developing the triage tool and implementing telemedicine urgency assessment in a larger network of hospitals in order to improve the integration of telemedicine into hospitals' organisational processes. The processes should include intensive training for the doctors involved in telemedical triage. Trial registration: DRKS00013207.
MeSH term(s)	Adult ; Canada ; Child ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Telemedicine/methods ; Triage/methods
Language	English
Publishing date	2022-05-26
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0269058
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Article ; Online: Evaluation of a Health Information Exchange System for Geriatric Health Care in Rural Areas: Development and Technical Acceptance Study.

Pfeuffer, Nils / Beyer, Angelika / Penndorf, Peter / Leiz, Maren / Radicke, Franziska / Hoffmann, Wolfgang / van den Berg, Neeltje

JMIR human factors

2022 Volume 9, Issue 3, Page(s) e34568

Abstract: Background: Patients of geriatrics are often treated by several health care providers at the same time. The spatial, informational, and organizational separation of these health care providers can hinder the effective treatment of these patients.: ... ...

Abstract	Background: Patients of geriatrics are often treated by several health care providers at the same time. The spatial, informational, and organizational separation of these health care providers can hinder the effective treatment of these patients. Objective: This study aimed to develop a regional health information exchange (HIE) system to improve HIE in geriatric treatment. This study also evaluated the usability of the regional HIE system and sought to identify barriers to and facilitators of its implementation. Methods: The development of the regional HIE system followed the community-based participatory research approach. The primary outcomes were the usability of the regional HIE system, expected implementation barriers and facilitators, and the quality of the developmental process. Data were collected and analyzed using a mixed methods approach. Results: A total of 3 focus regions were identified, 22 geriatric health care providers participated in the development of the regional HIE system, and 11 workshops were conducted between October 2019 and September 2020. In total, 12 participants responded to a questionnaire. The main results were that the regional HIE system should support the exchange of assessments, diagnoses, medication, assistive device supply, and social information. The regional HIE system was expected to be able to improve the quality and continuity of care. In total, 5 adoption facilitators were identified. The main points were adaptability of the regional HIE system to local needs, availability to different patient groups and treatment documents, web-based design, trust among the users, and computer literacy. A total of 13 barriers to adoption were identified. The main expected barriers to implementation were lack of resources, interoperability issues, computer illiteracy, lack of trust, privacy concerns, and ease-of-use issues. Conclusions: Participating health care professionals shared similar motivations for developing the regional HIE system, including improved quality of care, reduction of unnecessary examinations, and more effective health care provision. An overly complicated registration process for health care professionals and the patients' free choice of their health care providers hinder the effectiveness of the regional HIE system, resulting in incomplete patient health information. However, the web-based design of the system bridges interoperability problems that exist owing to the different technical and organizational structures of the health care facilities involved. The regional HIE system is better accepted by health care professionals who are already engaged in an interdisciplinary, geriatric-focused network. This might indicate that pre-existing cross-organizational structures and processes are prerequisites for using HIE systems. The participatory design supports the development of technologies that are adaptable to regional needs. Health care providers are interested in participating in the development of an HIE system, but they often lack the required time, knowledge, and resources.
Language	English
Publishing date	2022-09-15
Publishing country	Canada
Document type	Journal Article
ISSN	2292-9495
ISSN (online)	2292-9495
DOI	10.2196/34568
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Conference proceedings: Offene Versorgungsbedarfe bei Menschen mit Demenz – eine Querschnittsanalyse aus der InDePendent-Studie

Kleinke, Fabian / Michalowsky, Bernhard / Rädke, Anika / Mühlichen, Franka / Scharf, Annelie / Penndorf, Peter / van den Berg, Neeltje / Hoffmann, Wolfgang

2023 , Page(s) 23dkvf321

Event/congress	22. Deutscher Kongress für Versorgungsforschung (DKVF); Berlin; Deutsches Netzwerk Versorgungsforschung; 2023
Keywords	Medizin, Gesundheit
Publishing date	2023-10-02
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/23dkvf321
Database	German Medical Science

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Article ; Online: Designer molecules of the synaptic organizer MDGA1 reveal 3D conformational control of biological function.

Lee, Hubert / Chofflet, Nicolas / Liu, Jianfang / Fan, Shanghua / Lu, Zhuoyang / Resua Rojas, Martin / Penndorf, Patrick / Bailey, Aaron O / Russell, William K / Machius, Mischa / Ren, Gang / Takahashi, Hideto / Rudenko, Gabby

The Journal of biological chemistry

2023 Volume 299, Issue 4, Page(s) 104586

Abstract: MDGAs (MAM domain-containing glycosylphosphatidylinositol anchors) are synaptic cell surface molecules that regulate the formation of trans-synaptic bridges between neurexins (NRXNs) and neuroligins (NLGNs), which promote synaptic development. Mutations ... ...

Abstract	MDGAs (MAM domain-containing glycosylphosphatidylinositol anchors) are synaptic cell surface molecules that regulate the formation of trans-synaptic bridges between neurexins (NRXNs) and neuroligins (NLGNs), which promote synaptic development. Mutations in MDGAs are implicated in various neuropsychiatric diseases. MDGAs bind NLGNs in cis on the postsynaptic membrane and physically block NLGNs from binding to NRXNs. In crystal structures, the six immunoglobulin (Ig) and single fibronectin III domains of MDGA1 reveal a striking compact, triangular shape, both alone and in complex with NLGNs. Whether this unusual domain arrangement is required for biological function or other arrangements occur with different functional outcomes is unknown. Here, we show that WT MDGA1 can adopt both compact and extended 3D conformations that bind NLGN2. Designer mutants targeting strategic molecular elbows in MDGA1 alter the distribution of 3D conformations while leaving the binding affinity between soluble ectodomains of MDGA1 and NLGN2 intact. In contrast, in a cellular context, these mutants result in unique combinations of functional consequences, including altered binding to NLGN2, decreased capacity to conceal NLGN2 from NRXN1β, and/or suppressed NLGN2-mediated inhibitory presynaptic differentiation, despite the mutations being located far from the MDGA1-NLGN2 interaction site. Thus, the 3D conformation of the entire MDGA1 ectodomain appears critical for its function, and its NLGN-binding site on Ig1-Ig2 is not independent of the rest of the molecule. As a result, global 3D conformational changes to the MDGA1 ectodomain via strategic elbows may form a molecular mechanism to regulate MDGA1 action within the synaptic cleft.
MeSH term(s)	Neural Cell Adhesion Molecules/genetics ; Neural Cell Adhesion Molecules/metabolism ; Synapses/metabolism ; Binding Sites ; Immunoglobulins/genetics ; Immunoglobulins/metabolism ; Molecular Conformation ; Cell Adhesion Molecules, Neuronal/genetics ; Cell Adhesion Molecules, Neuronal/metabolism
Chemical Substances	Neural Cell Adhesion Molecules ; Immunoglobulins ; Cell Adhesion Molecules, Neuronal
Language	English
Publishing date	2023-03-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2997-x
ISSN	1083-351X ; 0021-9258
ISSN (online)	1083-351X
ISSN	0021-9258
DOI	10.1016/j.jbc.2023.104586
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Article ; Online: Levels of and determinants for physical activity and physical inactivity in a group of healthy elderly people in Germany: Baseline results of the MOVING-study.

Kleinke, Fabian / Penndorf, Peter / Ulbricht, Sabina / Dörr, Marcus / Hoffmann, Wolfgang / van den Berg, Neeltje

PloS one

2020 Volume 15, Issue 8, Page(s) e0237495

Abstract: Background: Low levels of physical activity (PA) and high levels of physical inactivity (PI) are associated with higher mortality and cardiovascular diseases. Higher age is associated with a decrease of PA, only 2.4-29% of ≥60 year-olds achieve the PA ... ...

Abstract	Background: Low levels of physical activity (PA) and high levels of physical inactivity (PI) are associated with higher mortality and cardiovascular diseases. Higher age is associated with a decrease of PA, only 2.4-29% of ≥60 year-olds achieve the PA times recommended by WHO. The aim of this study was to identify levels of and determinants for moderate PA, overall PA and PI in a sample of individuals aged ≥65 years. Methods: We analyzed baseline data from an intervention-study aiming to increase PA and decrease PI by automatically generated feedback letters to objectively measured PA and PI. Recruitment was multimodal including re-contacting participants of previous studies and advertisements in regional public buses and newspapers. At baseline, participants wore an accelerometer over a period of 7 consecutive days. PA was categorized using cut-points suggested by Freedsoon 1998 in light, moderate and vigorous physical intensity as well as physical inactivity. Potential determinants (self-efficacy, education) were measured by questionnaires or in a physical examination (BMI). Multiple linear regression models were fitted to identify determinants for PA and PI. Results: N = 199 persons (mean age 71.0 years (SD 4.9), 59.3% female) participated in the study. The weekly amount of overall PA for men was on average 1,821 minutes (SD 479.1), for women on average 1,929 minutes (SD 448.8). 79.7% of the women and 72.8% of the men achieved the WHO recommendation of 30 minutes moderate PA/day at baseline. The time of PI during the observation time period of 7 days was on average 4,057 minutes in men and 3,973 minutes in women. In males, age was found to be a significant negative determinant for overall PA (p = 0.002) and for moderate PA (p<0.001). Higher education was positively associated with higher levels of overall PA (p = 0.013) and moderate PA (p = 0.06) in men. BMI was a significant negative determinant for overall PA both in men (p = 0.039) and women (p = 0.032) as well as for moderate PA for women (p = 0.009). Only in women, not in men, self-efficacy was to be a significant positive determinant for overall PA (p = 0.020) as well as negatively associated with PI (p = 0.006). Discussion: The participants of our study showed high levels of PA. This is likely due to selection bias in this convenience sample. However, also levels of PI are very high and those correspond with average levels in the German population. The determinants for higher PA and lower PI differed between males and females. Thus, strategies for improving PA and decrease PI are likely different with respect to sex and should take individual factors (e.g. age, BMI) into account. Trial registration number: DRKS00010410 Date: 17 May 2017.
MeSH term(s)	Aged ; Aged, 80 and over ; Body Mass Index ; Educational Status ; Exercise ; Female ; Germany ; Humans ; Linear Models ; Male ; Self Efficacy
Language	English
Publishing date	2020-08-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0237495
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Conference proceedings: Übernahme von ärztlichen Tätigkeiten in der primären Demenzpflege – eine randomisierte, kontrollierte Crossover-Interventionsstudie zur Prüfung der Wirksamkeit und Kosteneffizienz der erweiterten Pflege in Deutschland

Mühlichen, Franka / Michalowsky, Bernhard / Raedke, Anika / Platen, Moritz / Mohr, Wiebke / Scharf, Annelie / Kleinke, Fabian / Penndorf, Peter / Hoffmann, Wolfgang

2022 , Page(s) V–04–01

Event/congress	56. Kongress für Allgemeinmedizin und Familienmedizin; Greifswald; Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin; 2022
Keywords	Medizin, Gesundheit
Publishing date	2022-09-15
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/22degam019
Database	German Medical Science

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Conference proceedings: Übernahme von ärztlichen Tätigkeiten durch Pflegefachpersonen in der Versorgung von Menschen mit Demenz – Modellvorhaben der erweiterten Pflegerolle in Deutschland

Mühlichen, Franka / Michalowsky, Bernhard / Rädke, Anika / Platen, Moritz / Mohr, Wiebke / Scharf, Annelie / Kleinke, Fabian / Penndorf, Peter / Hoffmann, Wolfgang

2022 , Page(s) 22dkvf181

Event/congress	21. Deutscher Kongress für Versorgungsforschung (DKVF); Potsdam; Deutsches Netzwerk Versorgungsforschung; 2022
Keywords	Medizin, Gesundheit
Publishing date	2022-09-30
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/22dkvf181
Database	German Medical Science

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Article ; Online: Advanced nursing practice and interprofessional dementia care (InDePendent): study protocol for a multi-center, cluster-randomized, controlled, interventional trial.

Kleinke, Fabian / Michalowsky, Bernhard / Rädke, Anika / Platen, Moritz / Mühlichen, Franka / Scharf, Annelie / Mohr, Wiebke / Penndorf, Peter / Bahls, Thomas / van den Berg, Neeltje / Hoffmann, Wolfgang

Trials

2022 Volume 23, Issue 1, Page(s) 290

Abstract: Background: A redistribution of tasks between specialized nurses and primary care physicians, i.e., models of advanced nursing practice, has the potential to improve the treatment and care of the growing number of people with dementia (PwD). Especially ... ...

Abstract	Background: A redistribution of tasks between specialized nurses and primary care physicians, i.e., models of advanced nursing practice, has the potential to improve the treatment and care of the growing number of people with dementia (PwD). Especially in rural areas with limited access to primary care physicians and specialists, these models might improve PwD's quality of life and well-being. However, such care models are not available in Germany in regular healthcare. This study examines the acceptance, safety, efficacy, and health economic efficiency of an advanced nursing practice model for PwD in the primary care setting in Germany. Methods: InDePendent is a two-arm, multi-center, cluster-randomized controlled intervention study. Inclusion criteria are age ≥70 years, cognitively impaired (DemTect ≤8) or formally diagnosed with dementia, and living in the own home. Patients will be recruited by general practitioners or specialists. Randomization is carried out at the physicians' level in a ratio of 1:2 (intervention vs. waiting-control group). After study inclusion, all participants will receive a baseline assessment and a follow-up assessment after 6 months. Patients of the intervention group will receive advanced dementia care management for 6 months, carried out by specialized nurses, who will conduct certain tasks, usually carried out by primary care physicians. This includes a standardized assessment of the patients' unmet needs, the generation and implementation of an individualized care plan to address the patients' needs in close coordination with the GP. PwD in the waiting-control group will receive routine care for 6 months and subsequently become part of the intervention group. The primary outcome is the number of unmet needs after 6 months measured by the Camberwell Assessment of Need for the Elderly (CANE). The primary analysis after 6 months is carried out using multilevel models and will be based on the intention-to-treat principle. Secondary outcomes are quality of life, caregiver burden, acceptance, and cost-effectiveness. In total, n=465 participants are needed to assess significant differences in the number of unmet needs between the intervention and control groups. Discussion: The study will provide evidence about the acceptance, efficacy, and cost-effectiveness of an innovative interprofessional concept based on advanced nursing care. Results will contribute to the implementation of such models in the German healthcare system. The goal is to improve the current treatment and care situation for PwD and their caregivers and to expand nursing roles. Trial registration: ClinicalTrials.gov NCT04741932 . Registered on 2 February 2021.
MeSH term(s)	Aged ; Caregivers ; Dementia/diagnosis ; Dementia/therapy ; Germany ; Humans ; Multicenter Studies as Topic ; Nurse's Role ; Quality of Life ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2022-04-11
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-022-06249-1
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