[Online information for relatives of critically ill patients : Pilot test of the usability of an ICU families website]. / Onlineinformation für Angehörige von kritisch Kranken : Pilottestung zur Nutzbarkeit der ICU Families Website.

BACKGROUND: Relatives of intensive care patients have a very high need for information. This is due to the acute and serious, often life-threatening illness of the patients and the very complex and technical environment of an intensive care unit (ICU). Unmet needs for information can increase anxiety, sleep disorders, stress, and depressive symptoms in the relatives. OBJECTIVES: The potential of the ICU families website in terms of usability and functionality during real-time testing were evaluated. METHODS: The ICU families project created a dynamic online information platform in the form of a password-protected website. It contains pictures, written explanations, 5 movies, a forum and a diary function. The usability of the website was tested among 10 lay people and 10 experts (7 nurses and 3 physicians) according to the Think Aloud Method. RESULTS: The outcome is qualitative feedback based on video documentation by laypeople and suggestions by experts. Criticisms mentioned by the test subjects were insufficient image material, small size of the operator contact link and lack of a home button. With a mean of 9.1 (rating scale, 0 = very poor, 10 = very good), the website was almost universally recommended by the experts. CONCLUSIONS: This usability test of a website for relatives of ICU patients conducted among 20 test subjects showed the biggest challenges related to solving individual test scenarios and provided valuable hints for improving website usability. Features of the website highlighted as positive were the clear layout, the symbols, the diary and the consideration of children. This information was used to improve the site for subsequent roll-out in a randomized, controlled and multicentre study.

Gut microbiota, dietary intakes and intestinal permeability reflected by serum zonulin in women.

PURPOSE: Increased gut permeability causes the trespass of antigens into the blood stream which leads to inflammation. Gut permeability reflected by serum zonulin and diversity of the gut microbiome were investigated in this cross-sectional study involving female study participants with different activity and BMI levels. METHODS: 102 women were included (BMI range 13.24-46.89 kg m-2): Anorexia nervosa patients (n = 17), athletes (n = 20), normal weight (n = 25), overweight (n = 21) and obese women (n = 19). DNA was extracted from stool samples and subjected to 16S rRNA gene analysis (V1-V2). Quantitative Insights Into Microbial Ecology (QIIME) was used to analyze data. Zonulin was measured with ELISA. Nutrient intake was assessed by repeated 24-h dietary recalls. We used the median of serum zonulin concentration to divide our participants into a "high-zonulin" (> 53.64 ng/ml) and "low-zonulin" (< 53.64 ng/ml) group. RESULTS: The alpha-diversity (Shannon Index, Simpson Index, equitability) and beta-diversity (unweighted and weighted UniFrac distances) of the gut microbiome were not significantly different between the groups. Zonulin concentrations correlated significantly with total calorie-, protein-, carbohydrate-, sodium- and vitamin B12 intake. Linear discriminant analysis effect size (LEfSe) identified Ruminococcaceae (LDA = 4.163, p = 0.003) and Faecalibacterium (LDA = 4.151, p = 0.0002) as significantly more abundant in the low zonulin group. CONCLUSION: Butyrate-producing gut bacteria such as Faecalibacteria could decrease gut permeability and lower inflammation. The diversity of the gut microbiota in women does not seem to be correlated with the serum zonulin concentration. Further interventional studies are needed to investigate gut mucosal permeability and the gut microbiome in the context of dietary factors.

Impaired probabilistic classification learning with feedback in patients with major depression.

BACKGROUND: The function of basal ganglia (BG) in the pathophysiology of major depression (MD) is still unclear. Recent research found changes in BG regarding size, structure and cerebral perfusion in patients with MD. Neuroimaging shows recruitment of the striatum during feedback (FB) based incidental learning of probabilistic classification learning, while the medial temporal lobe (MTL) is associated with paired associate (PA) based incidental learning. The purpose of this study was to evaluate whether FB-based incidental learning is affected in MD. METHODS: The FB and PA versions of the weather prediction task (WPT), a task of incidental probabilistic classification learning, were completed by patients with MD (n=44) and healthy controls (n=44). In FB-learning the participants received either a "thumbs-up" or "thumbs-down" message according to their right or wrong classification of cards to a certain kind of weather (either rainy or fine), while in PA learning no classification was required. Severity of MD was rated on the Beck Depression Inventory and Hamilton Rating Scale for depression. RESULTS: Patients with MD were selectively impaired on the FB task relative to controls (p<0.05), while no significant difference was found for PA learning between the two groups. Furthermore, there were no significant differences between FB and PA-learning within the patient and control groups. CONCLUSION: Our results indicate a distinct impairment on the FB-based version of the weather prediction task. These findings implicate disturbed reinforcement learning in this group of patients.

[Predictors of mental and physical quality of life in Huntington's disease]. / Prädiktoren der psychischen und physischen Lebensqualität beim Morbus Huntington.

BACKGROUND: The assessment of health-related quality of life (hrQoL) is an important tool in therapy studies and in the treatment of patients with Huntington's disease (HD). In the absence of causal interventions, HD therapy targets the alleviation of symptoms aiming to improve impaired hrQoL. The aim of this study was to determine the impact of disease characteristics on hrQoL in HD. METHODS: A total of 80 genetically confirmed HD patients underwent an assessment using the Unified Huntington's Disease Rating Scale, the Beck Depression Inventory, the Hamilton Rating Scale and the SF-36, a scale for the assessment of physical and mental QoL. RESULTS: Multiple regression analysis revealed that health-related physical and mental QoL was considerably influenced by the functional capacity. The mental QoL also correlated with the degree of depressive symptoms, age and the number of CAG repeats. However, there was no statistical relation between QoL and motor and cognitive abilities. DISCUSSION: This study underlines the relationship between function capacity and depressive symptoms with mental and physical QoL. This is the first time that hrQoL has been investigated in a German speaking cohort. The results are in accordance with previous studies of hrQoL in HD.

[Verbal memory in patients with major depression]. / Das verbale Gedächtnis bei depressiven Patienten.

INTRODUCTION: Patients with major depression commonly report memory deficits but studies on this topic have shown inconsistent results. The aim of this study was to determine whether patients with major depression showed any differences in explicit verbal memory compared to healthy controls. MATERIAL AND METHODS: We used the California verbal learning test (CVLT) in order to compare the explicit verbal memory of 30 patients (21 women and 9 men) to a healthy control group (23 women and 10 men). RESULTS: The results showed no significant differences between verbal memory performance of patients with major depression and healthy controls. DISCUSSION: Verbal memory of depressive patients with antidepressant pharmacotherapy showed no significant differences compared to a healthy control group. It can be assumed that verbal memory in depression depends on variable parameters (e.g. age, severity and duration of depression and medication). More studies with a larger number of patients should be conducted to obtain reliable results about explicit verbal memory in depression.