TY - GEN A1 - Boldt, Julia A1 - Leber, Alexander W. A1 - Bonaventura, Klaus A1 - Sohns, Christian A1 - Stula, Martin A1 - Huppertz, Alexander A1 - Haverkamp, Wilhelm A1 - Dorenkamp, Marc T1 - Cost-effectiveness of cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary artery disease in Germany T2 - Postprints der Universität Potsdam Humanwissenschaftliche Reihe N2 - Background: Recent studies have demonstrated a superior diagnostic accuracy of cardiovascular magnetic resonance (CMR) for the detection of coronary artery disease (CAD). We aimed to determine the comparative cost-effectiveness of CMR versus single-photon emission computed tomography (SPECT). Methods: Based on Bayes' theorem, a mathematical model was developed to compare the cost-effectiveness and utility of CMR with SPECT in patients with suspected CAD. Invasive coronary angiography served as the standard of reference. Effectiveness was defined as the accurate detection of CAD, and utility as the number of quality-adjusted life-years (QALYs) gained. Model input parameters were derived from the literature, and the cost analysis was conducted from a German health care payer's perspective. Extensive sensitivity analyses were performed. Results: Reimbursement fees represented only a minor fraction of the total costs incurred by a diagnostic strategy. Increases in the prevalence of CAD were generally associated with improved cost-effectiveness and decreased costs per utility unit (Delta QALY). By comparison, CMR was consistently more cost-effective than SPECT, and showed lower costs per QALY gained. Given a CAD prevalence of 0.50, CMR was associated with total costs of (sic)6,120 for one patient correctly diagnosed as having CAD and with (sic)2,246 per Delta QALY gained versus (sic)7,065 and (sic)2,931 for SPECT, respectively. Above a threshold value of CAD prevalence of 0.60, proceeding directly to invasive angiography was the most cost-effective approach. Conclusions: In patients with low to intermediate CAD probabilities, CMR is more cost-effective than SPECT. Moreover, lower costs per utility unit indicate a superior clinical utility of CMR. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 551 KW - cost-effectiveness KW - cardiovascular magnetic resonance KW - scintigraphy KW - coronary angiography KW - coronary artery disease Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-430107 SN - 1866-8364 IS - 551 ER - TY - GEN A1 - Wolff, Wanja A1 - Baumgarten, Franz A1 - Brand, Ralf T1 - Reduced self-control leads to disregard of an unfamiliar behavioral option BT - an experimental approach to the study of neuroenhancement N2 - Background: Neuroenhancement (NE), the use of psychoactive substances in order to enhance a healthy individual's cognitive functioning from a proficient to an even higher level, is prevalent in student populations. According to the strength model of self-control, people fail to self-regulate and fall back on their dominant behavioral response when finite self-control resources are depleted. An experiment was conducted to test the hypothesis that ego-depletion will prevent students who are unfamiliar with NE from trying it. Findings: 130 undergraduates, who denied having tried NE before (43% female, mean age = 22.76 +/- 4.15 years old), were randomly assigned to either an ego-depletion or a control condition. The dependent variable was taking an "energy-stick" (a legal nutritional supplement, containing low doses of caffeine, taurine and vitamin B), offered as a potential means of enhancing performance on the bogus concentration task that followed. Logistic regression analysis showed that ego-depleted participants were three times less likely to take the substance, OR = 0.37, p = .01. Conclusion: This experiment found that trying NE for the first time was more likely if an individual's cognitive capacities were not depleted. This means that mental exhaustion is not predictive for NE in students for whom NE is not the dominant response. Trying NE for the first time is therefore more likely to occur as a thoughtful attempt at self-regulation than as an automatic behavioral response in stressful situations. We therefore recommend targeting interventions at this inter-individual difference. Students without previous reinforcing NE experience should be provided with information about the possible negative health outcomes of NE. Reconfiguring structural aspects in the academic environment (e.g. lessening workloads) might help to deter current users. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 358 KW - Neuroenhancement KW - Self-control KW - Ego-depletion KW - Prevention Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-401386 ER - TY - GEN A1 - Wolff, Wanja A1 - Brand, Ralf T1 - Subjective stressors in school and their relation to neuroenhancement BT - a behavioral perspective on students' everyday life "doping" N2 - Background: The use of psychoactive substances to neuroenhance cognitive performance is prevalent. Neuroenhancement (NE) in everyday life and doping in sport might rest on similar attitudinal representations, and both behaviors can be theoretically modeled by comparable means-to-end relations (substance-performance). A behavioral (not substance-based) definition of NE is proposed, with assumed functionality as its core component. It is empirically tested whether different NE variants (lifestyle drug, prescription drug, and illicit substance) can be regressed to school stressors. Findings: Participants were 519 students (25.8 +/- 8.4 years old, 73.1% female). Logistic regressions indicate that a modified doping attitude scale can predict all three NE variants. Multiple NE substance abuse was frequent. Overwhelming demands in school were associated with lifestyle and prescription drug NE. Conclusions: Researchers should be sensitive for probable structural similarities between enhancement in everyday life and sport and systematically explore where findings from one domain can be adapted for the other. Policy makers should be aware that students might misperceive NE as an acceptable means of coping with stress in school, and help to form societal sensitivity for the topic of NE among our younger ones in general. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 356 KW - Neuroenhancement KW - stress KW - school KW - doping Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-401131 ER - TY - BOOK A1 - Mühlbauer, Thomas A1 - Roth, Ralf A1 - Kibele, Armin A1 - Behm, David George A1 - Granacher, Urs ED - Kröger, Christian ED - Roth, Klaus ED - Haag, Herbert T1 - Krafttraining mit Kindern und Jugendlichen BT - theoretische Grundlagen und praktische Umsetzung T3 - Praxisideen N2 - Dieser Band beschäftigt sich mit den theoretischen Grundlagen und der praktischen Umsetzung von Krafttraining mit Kindern und Jugendlichen. Ausgehend von der Kennzeichnung der körperlichen Situation und der Kraftentwicklung im Kindes- und Jugendalter werden die Effekte von Krafttraining bei Kindern und Jugendlichen aufgezeigt. Hierzu zählen neben Verbesserungen der Kraftausdauer, der Maximal- und Schnellkraft, die Förderung elementarer und sportartspezifischer Fertigkeiten sowie die günstige Beeinflussung gesundheitsrelevanter Faktoren (u.a. Verletzungshäufigkeit, Knochenstatus, kardio-vaskuläre und psycho-soziale Kennwerte). Im Anschluss werden neuronale und muskuläre Mechanismen zur Erklärung der trainingsbedingten Anpassungen beschrieben. Das Kernstück des Buches bildet die Darstellung und Beschreibung vielfältiger Übungsbeispiele für ein Krafttraining an Maschinen, mit Freihanteln, Zusatzgeräten, dem eigenen Körpergewicht und ein Sprungkrafttraining. Hierbei wurden insbesondere Übungen ausgewählt, die sich für den Einsatz im Schul- und Vereinssport eignen. Dieses Buch dient somit Lehrern, Übungsleitern und Trainern, ein zielgerichtetes Krafttraining mit Kindern und Jugendlichen wirkungsvoll und sicher durchzuführen. Y1 - 2013 SN - 978-3-7780-2581-9 IS - 58 PB - Hofmann CY - Schorndorf ER - TY - INPR A1 - Thieme, Holm A1 - Mehrholz, Jan A1 - Pohl, Marcus A1 - Behrens, Johann A1 - Dohle, Christian T1 - Mirror therapy for improving motor function after stroke T2 - Stroke : a journal of cerebral circulation Y1 - 2013 U6 - https://doi.org/10.1161/STROKEAHA.112.673087 SN - 0039-2499 VL - 44 IS - 1 SP - E1 EP - E2 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Mühlbauer, Thomas A1 - Besemer, Carmen A1 - Wehrle, Anja A1 - Gollhofer, Albert A1 - Granacher, Urs T1 - Relationship between strength; balance and mobility in children aged 7-10 years JF - Gait & posture N2 - The purpose of this study was to investigate the association between variables of lower extremity muscle strength, balance, and mobility assessed under various task conditions. Twenty-one healthy children (mean age: 9 +/- 1 years) were tested for their isometric and dynamic strength as well as for their steady-state, proactive, and reactive balance and mobility. Balance and mobility tests were conducted under single and dual task conditions. Significant positive correlations were detected between measures of isometric and dynamic leg muscle strength. Hardly any significant associations were observed between variables of strength and balance/mobility and between measures of steady-state, proactive, and reactive balance. Additionally, no significant correlations were detected between balance/mobility tests performed under single and dual task conditions. The predominately non-significant correlations between different balance components and mobility imply that balance and mobility performance is task specific. Further, strength and balance/mobility as well as balance under single and dual task conditions seem to be independent of each other and may have to be tested and trained complementarily. KW - Steady-state balance KW - Proactive/reactive balance KW - Maximal isometric force KW - Jumping height KW - Single/dual tasking KW - Cognitive/motor interference Y1 - 2013 U6 - https://doi.org/10.1016/j.gaitpost.2012.06.022 SN - 0966-6362 VL - 37 IS - 1 SP - 108 EP - 112 PB - Elsevier CY - Clare ER - TY - JOUR A1 - Granacher, Urs A1 - Lacroix, Andre A1 - Mühlbauer, Thomas A1 - Röttger, Katrin A1 - Gollhofer, Albert T1 - Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults JF - Gerontology N2 - Background: Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance. Objective: The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors. Methods: Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 +/- 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 +/- 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested. Results: Program compliance was excellent with participants of the INT group completing 92% of the training sessions. Significant group x test interactions were found for the maximal isometric strength of the trunk flexors (34%, p < 0.001), extensors (21%, p < 0.001), lateral flexors (right: 48%, p < 0.001; left: 53%, p < 0.001) and left rotators (42%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11%, p < 0.001) and coronal plane (11%, p = 0.06) directions, for stride velocity (9%, p < 0.05), the coefficient of variation in stride velocity (31%, p < 0.05), the Functional Reach test (20%, p < 0.05) and the Timed Up and Go test (4%, p < 0.05) in favor of the INT group. Conclusion: CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training. KW - Elderly KW - Gait KW - Muscle strength KW - Physical performance KW - Postural balance Y1 - 2013 U6 - https://doi.org/10.1159/000343152 SN - 0304-324X VL - 59 IS - 2 SP - 105 EP - 113 PB - Karger CY - Basel ER - TY - JOUR A1 - Niemeyer, Helen A1 - Musch, Jochen A1 - Pietrowsky, Reinhard T1 - Publication Bias in meta-analyses of the efficacy of psychotherapeutic interventions for depression JF - Journal of consulting and clinical psychology N2 - Objective: The aim of this study was to assess whether systematic reviews investigating psychotherapeutic interventions for depression are affected by publication bias. Only homogeneous data sets were included, as heterogeneous data sets can distort statistical tests of publication bias. Method: We applied Begg and Mazumdar's adjusted rank correlation test, Egger's regression analysis, and the trim and fill procedure to assess the presence and magnitude of publication bias in all homogeneous data sets of systematic reviews published up to September 2010. Results: Thirty-one data sets reported in 19 meta-analyses fulfilled our inclusion criteria. Significant bias was detected in 5 (16.13%; rank correlation test) and 6 (19.35%; Egger's regression analysis) of these data sets. Applying the trim and fill procedure to amend presumably missing studies rarely changed the assessment of the efficacy of therapeutic interventions, with 2 exceptions. In 1 data set psychotherapy was no longer found to be significantly more efficacious than pharmacotherapy in reducing dropout at posttreatment when publication bias was taken into account. In the 2nd data set, after correcting for publication bias, there was no longer evidence that depressed patients without comorbid personality disorder profited more from psychotherapy and pharmacotherapy than patients with comorbid personality disorder. Conclusions: The results suggest that taken together, psychotherapy research for depression is only marginally affected by the selective reporting of positive outcomes. With 2 notable exceptions, correcting for publication bias did not change the evaluation of the efficacy of psychotherapeutic interventions. KW - depression KW - publication bias KW - meta-analysis KW - psychotherapy research Y1 - 2013 U6 - https://doi.org/10.1037/a0031152 SN - 0022-006X VL - 81 IS - 1 SP - 58 EP - 74 PB - American Psychological Association CY - Washington ER - TY - JOUR A1 - Dorenkamp, Marc A1 - Bonaventura, Klaus A1 - Leber, Alexander W. A1 - Boldt, Julia A1 - Sohns, Christian A1 - Boldt, Leif-Hendrik A1 - Haverkamp, Wilhelm A1 - Frei, Ulrich A1 - Roser, Mattias T1 - Potential lifetime cost-effectiveness of catheter-based renal sympathetic denervation in patients with resistant hypertension JF - European heart journal N2 - Aims Recent studies have demonstrated the safety and efficacy of catheter-based renal sympathetic denervation (RDN) for the treatment of resistant hypertension. We aimed to determine the cost-effectiveness of this approach separately for men and women of different ages. Methods and results A Markov state-transition model accounting for costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness was developed to compare RDN with best medical therapy (BMT) in patients with resistant hypertension. The model ran from age 30 to 100 years or death, with a cycle length of 1 year. The efficacy of RDN was modelled as a reduction in the risk of hypertension-related disease events and death. Analyses were conducted from a payer's perspective. Costs and QALYs were discounted at 3% annually. Both deterministic and probabilistic sensitivity analyses were performed. When compared with BMT, RDN gained 0.98 QALYs in men and 0.88 QALYs in women 60 years of age at an additional cost of (sic)2589 and (sic)2044, respectively. As the incremental cost-effectiveness ratios increased with patient age, RDN consistently yielded more QALYs at lower costs in lower age groups. Considering a willingness-to-pay threshold of (sic)35 000/QALY, there was a 95% probability that RDN would remain cost-effective up to an age of 78 and 76 years in men and women, respectively. Cost-effectiveness was influenced mostly by the magnitude of effect of RDN on systolic blood pressure, the rate of RDN non-responders, and the procedure costs of RDN. Conclusion Renal sympathetic denervation is a cost-effective intervention for patients with resistant hypertension. Earlier treatment produces better cost-effectiveness ratios. KW - Cost-effectiveness KW - Resistant hypertension KW - Renal sympathetic denervation KW - Prevention KW - Cardiovascular disease Y1 - 2013 U6 - https://doi.org/10.1093/eurheartj/ehs355 SN - 0195-668X VL - 34 IS - 6 SP - 451 EP - + PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Beijersbergen, Chantal M. I. A1 - Granacher, Urs A1 - Vandervoort, A. A. A1 - DeVita, P. A1 - Hortobagyi, Tibor T1 - The biomechanical mechanism of how strength and power training improves walking speed in old adults remains unknown JF - Ageing research reviews : ARR N2 - Maintaining and increasing walking speed in old age is clinically important because this activity of daily living predicts functional and clinical state. We reviewed evidence for the biomechanical mechanisms of how strength and power training increase gait speed in old adults. A systematic search yielded only four studies that reported changes in selected gait biomechanical variables after an intervention. A secondary analysis of 20 studies revealed an association of r(2) = 0.21 between the 22% and 12% increase, respectively, in quadriceps strength and gait velocity in 815 individuals age 72. In 6 studies, there was a correlation of r(2) = 0.16 between the 19% and 9% gains in plantarflexion strength and gait speed in 240 old volunteers age 75. In 8 studies, there was zero association between the 35% and 13% gains in leg mechanical power and gait speed in 150 old adults age 73. To increase the efficacy of intervention studies designed to improve gait speed and other critical mobility functions in old adults, there is a need for a paradigm shift from conventional (clinical) outcome assessments to more sophisticated biomechanical analyses that examine joint kinematics, kinetics, energetics, muscle-tendon function, and musculoskeletal modeling before and after interventions. KW - Aging KW - Strength training KW - Power training KW - Gait biomechanics Y1 - 2013 U6 - https://doi.org/10.1016/j.arr.2013.03.001 SN - 1568-1637 VL - 12 IS - 2 SP - 618 EP - 627 PB - Elsevier CY - Clare ER -