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Wenn es um die Repräsentation des menschlichen Körpers im Hirn geht, erscheint bei den meisten unweigerlich das Bild des Homunkulus vor dem geistigen Auge. Mit seinen unproportionierten Körperteilen, den langen Fingern, dem großen Mund und der plumpen Zunge hat dieser einen unauslöschlichen Eindruck hinterlassen. Letztes Jahr feierte er seinen 70. Geburtstag – Zeit, zu schauen, ob er nicht viel agiler ist als bisher angenommen.

Darstellung des Themas : Das Interesse und die Nachfrage nach einer kompetenten Beratung im Themenbereich Stillen nach abgeschlossener Behandlung eines Mammakarzinoms nehmen zu. Dies aufgrund des zunehmenden maternalen Alters und der damit steigenden Wahrscheinlichkeit nach der Diagnose eines Mammakarzinoms schwanger zu werden. In dieser Bachelorarbeit werden physische und psychische Faktoren eruiert, welche das Stillen nach abgeschlossener Behandlung eines Mammakarzinoms beeinflussen. Methoden : Zur Beantwortung der Fragestellung wurde ein narratives Literaturreview durchgeführt. Es werden Ergebnisse aus einer Mixed-Methods-Studie, einer qualitativen Studie, einer quantitativen Kohortenstudie und einer qualitativen Fallstudie analysiert. Ein Betroffenengespräch fliesst ebenfalls mit ein. Ergebnisse : Das Stillen nach abgeschlossener Behandlung eines Mammakarzinoms ist sicher und durchführbar, jedoch von einigen physischen und psychischen Faktoren abhängig. Der physische Hauptfaktor ist die verminderte Muttermilchmenge; dieser wird unter anderem durch die Operationstechnik und Behandlungsmethoden beeinflusst. Einer der wichtigsten psychischen Faktoren stellt die Unterstützung der Betroffenen durch das Umfeld und Gesundheitsfachpersonal dar. Schlussfolgerung : Gut geschultes Gesundheitsfachpersonal ist wichtig und notwendig für die adäquate Betreuung der Betroffenen. Die Stillberatung sollte für alle Betroffenen zugänglich sein und Wünsche und Bedürfnisse haben Priorität.

There is growing evidence that mobile health (mHealth) applications can assist patients with chronic conditions. However, most mHealth apps are isolated from healthcare professional (HCP) workflows and IT infrastructure. The resulting fragmentation of digital support in healthcare calls for integrating architectures. They would benefit patients, HCPs, product managers, and software developers. Our analysis of existing architectures has revealed valuable architectural elements, but none of the analyzed architectures provided sufficient integration for the chronically ill. Therefore, we propose an architecture for integrated mHealth solutions. We followed a design science research approach and performed all activities of the DSRM Process Model. By forming a closed control loop and engaging HCPs, the architecture is designed to improve patient adherence to treatment, health literacy, and recall of recommendations and information. The resulting Closing-the-Loop Architecture (LoopArt) deploys three software agents: a Health Literacy Agent, an Adherence Agent, and a Conversational Agent. For demonstration purposes, the Health Literacy Agent was implemented for obese patients as an integrated system consisting of a mHealth app and a collaboration tool as part of the electronic medical record (EMR).

Medical chatbots are already used regularly by patients and health care professionals (HCPs). By the end of 2020, the majority of practicing HCPs were born between 1980 to 1994. In other words, most HCPs currently belong to Generation Y, who are generally assumed to be more open towards new digital technologies. The aim of this study was to evaluate HCP acceptance and influencing factors on the latter of a chatbot-based information platform as a proxy for information that HCPs usually provide to patients. This research of 99 HCP showed that system relevance and the innovative elements of the chatbot itself were essential factors in perceiving the chatbot as useful. The innovative elements also had a positive effect on perceived ease of use. Our study provides insights into user acceptance of chatbots supporting the work of HCPs and is a starting point for further discussions and generational change in the labor market for HCPs.

2.L. Workshop, The on-going digital transformation of societies and our health system has to be taken into account when it comes to child and adolescent public health. Digitalization is also rapidly changing European (public) health systems, impacting the design of healthcare, the delivery of health education, and the necessary training of health professionals working with children and adolescents. Digital health literacy is rooted in health literacy and comprises the competencies to find, understand, appraise, and apply health information and services. Digital health literacy is becoming increasingly relevant to navigate the health system, to be informed and interact on health topics, and to manage one's own health. Digital health literacy not only has a positive impact on health it is also considered a key element to a successful transition to digital health and digital public health. Children and adolescents are born into a digital world and already at young age they start to engage with digital technologies and applications. This familiarity does not, however, imply a high digital health literacy, the competencies relevant to digital health literacy must still be trained and learned. The earlier children and adolescents develop these competencies, the earlier they can take responsibility for their health behaviours and health. Schools and educational institutions are therefore crucial concerning the promotion of digital health literacy. For its promotion it needs knowledge regarding the concept, how it can be measured and effectively promoted. The objectives of this workshop are to: • Provide an introduction into the concept of digital health literacy and its relevance for child and adolescent public health • Provide an overview and current challenges of measuring digital health literacy. • Provide insights into first time representative data on school children's digital health literacy and a collaborative project in schools between public health and paediatrics. • To clarify

Healthcare information technology holds great potential for improving services in hospital environments. This transformation is fueled by the fact that current extraordinary situations, such as the COVID-19 pandemic, indicate that the realization of digital health innovation is essential to delivering most healthcare services for patients. To facilitate an environment that allows digital innovation and integration of internal and external stakeholders a movement toward a digital hospital ecosystem is needed. We conducted a structured literature review to identify the current state of knowledge about enabling mechanisms that facilitate the development of a digital hospital ecosystem. Therefore, we draw on the current literature on digital infrastructures and platform ecosystems. We identified the challenges hospitals face during their transformation and address them by deriving key mechanisms of the digital hospital ecosystem. Thus, this study contributes to research by presenting insights into the transformation toward a digital hospital ecosystem.

1950 erschien das erste Buch über ihn. Mit den unproportionierten Körperteilen, den langen Fingern, den dicken Lippen und der großen Zunge hat der Homunkulus – lateinisch für „Menschlein“ – einen bleibenden Eindruck hinterlassen. Bis heute repräsentiert er den Körper des Menschen im Gehirn. Zeit, zu schauen, was sich über die Jahre bei ihm verändert hat.

Der Public-Health-Forschung und -Praxis kommt die Rolle zu, Risiken und Chancen der digitalen Transformation des Gesundheitswesens zu adressieren und dabei neue digitale Gesundheitsdeterminanten wie zum Beispiel die digitale Gesundheitskompetenz zu berücksichtigen.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), Eine wesentliche Voraussetzung für eine erfolgreiche digitale Transformation des Gesundheitswesens ist eine gut ausgeprägte digitale Gesundheitskompetenz (DGK) der Bevölkerung. DGK ist die Fähigkeit zum Umgang mit gesundheitsbezogenen digitalen Informationen und Informationsmöglichkeiten mit dem Ziel, Gesundheit und Wohlbefinden für sich selbst und sein Umfeld zu fördern und zu erhalten. Der Artikel beleuchtet die Diskussion über DGK, vorhandene Studien und die darin verwendeten Messinstrumente sowie die Datenlage in Deutschland und erörtert aktuelle Herausforderungen. DGK besteht aus verschiedenen Teilkompetenzen, die aktuelle digitale Informationsverhalten, -möglichkeiten und -risiken widerspiegeln. Die Datenlage ist, aufgrund unterschiedlicher Studiendesigns und -instrumente, sehr heterogen, was die Aussagekraft limitiert. Zwei repräsentative Studien, HLS-GER 2 der Universität Bielefeld sowie die Studie der AOK Rheinland/Hamburg und des Leibniz-WissenschaftsCampus, weisen trotz unterschiedlicher Methoden auf einen hohen Anteil von Menschen mit geringer DGK hin. National wie international zeigt sich, dass die DGK einem sozialen Gradienten unterliegt und mit Bildungsniveau, Sozialstatus, finanzieller Deprivation und Alter assoziiert ist. Die DGK ist in Deutschland den vorliegenden Daten zufolge noch unzureichend; somit besteht ein großer Handlungsbedarf. Erforderliche gesetzliche Rahmenbedingungen sind gegeben, dennoch fehlt es an verlässlichen finanziellen Ressourcen ebenso an einer soliden Datengrundlage auf Bevölkerungsebene zu DGK. Damit ließen sich Vulnerabilitätsfaktoren identifizieren und die Implementation von Maßnahmen vorbereiten und evaluieren. Zudem bedarf es einer vertiefenden konzeptionellen Diskussion zur DGK, die an das etablierte Gesundheitskompetenzkonzept anknüpft und auch die gesundheitsbezogene Infodemie und ihre Folgen für die DGK aufgreift.

Digital technologies are changing our health system, health information and health communication, and digital health literacy is becoming increasingly important to ensure equitable access to health. Digital health literacy applies to all contexts of health and healthcare, such as health information seeking behavior, navigation of healthcare systems, and healthcare access. However, the concept of digital health literacy is constantly evolving due to continuous technological developments and their adoption in society and health system. One of the first to define ehealth were Norman and Skinner. Their concept is based on the concept of health literacy, to seek, understand, critically evaluate, and apply information. The talk will outline the development of the digital health literacy concept since Norman and Skinners’ definition in 2006 to the current understanding of digital health literacy in 2023. The technological changes and the increasingly digitalized societies have led not only to an expansion, but also higher specificity of the literacies embedded in the digital health literacy concept. Aim of the talk is to raise the understanding for the complexity and the relevance of digital health literacy in children and adolescents by exemplifying digital health literacy in the context of child and adolescent lives and health needs. The concept, however, is not without critique, which will be addressed and discussed with the audience.

Background: Ongoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings. Methods and participants: We developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed the Checklist for Reporting Results of Internet E-Surveys guideline. Results: The questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries were recorded. The highest educational needs were ‘professional development’, ‘prevention and lifestyle intervention’. Older age, more working experience in rheumatology and higher education levels were positively associated with higher postgraduate educational readiness. While more than half of the HPR were familiar with EULAR as an association and the respondents reported an increased interest in the content of the educational offerings, the courses and the annual congress were poorly attended due to a lack of awareness, comparatively high costs and language barriers. Conclusions: To promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers.

References: [1] Lars B. Hindenes et al. Variations in the circle of willis in a large population sample using 3D TOF angiography: The tromsø study. PLoS One, 15(11), 2020. [2] A. W. J. Hoksbergen et al. Absent collateral function of the circle of willis as risk factor for ischemic stroke. Cerebrovascular Diseases, 16(3):191–198, 2003. [3] T. van Seeters et al. Completeness of the circle of willis and risk of ischemic stroke in patients without cerebrovascular disease. Neuroradiology, 57:1247–1251, 2015. [4] Topcow: Topology-aware anatomical segmentation of the circle of willis for CTA and MRA. MICCAI 2023. https://topcow23.grand-challenge.org/topcow23/., Aims: The Circle of Willis (CoW) is an arterial anastomotic system formed by the principal arteries in the brain. Anatomical variants of the CoW are frequent and occur in a large part of the general population [1]. Not only does the length and caliber of vessel segments change, also the topology of the vessel tree is subject to variation. It is hypothesized that CoW variants can have an impact on the severity of stroke [2; 3]. As a first step in studying this relation we present a pipeline for annotating and extracting the CoW vessels in 3D angiographies and show some preliminary results on the topological variability in a stroke cohort. Methods: Leveraging the power of virtual reality (VR) we developed an efficient protocol for the 3D anatomical annotation of the CoW in MRA and CTA. This way we carefully annotated the CoW in a cohort of 115 stroke patients with dual imaging modalities, allowing us to analyze the CoW topological variability. Results: The results are twofold: (1) We present our dataset containing complete CoW vessel annotations on two common angiographic imaging modalities. This dataset is made publicly available [4] to help facilitate future CoW research. (2) As part of our preliminary analysis on the CoW topological variability we find all types of variants in our stroke cohort. The most common one was the absence of the posterior communicating arteries (Pcom). A complete CoW was found in less than 30% of the cohort. Outlook: We believe that our dataset can be of benefit to both clinicians and medical imaging researchers. Good quality data is critical for large-scale CoW characterization and the study of the effect of the angioarchitecture on cerebrovascular diseases.

Wenn wir weiterhin eine gute Gesundheitsversorgung wollen, müssen wir die knappen Fachkräfte am richtigen Ort einsetzen. Eine Diskussion aus System- und Organisationssicht.

Deep learning based approaches have been used to improve image quality in cone-beam computed tomography (CBCT), a medical imaging technique often used in applications such as imageguided radiation therapy, implant dentistry or orthopaedics. In particular, while deep learning methods have been applied to reduce various types of CBCT image artifacts arising from motion, metal objects, or lowdose acquisition, a comprehensive review summarizing the successes and shortcomings of these approaches, with a primary focus on the type of artifacts rather than the architecture of neural networks, is lacking in the literature. In this review, the data generation and simulation pipelines, and artifact reduction techniques are specifically investigated for each type of artifact. We provide an overview of deep learning techniques that have successfully been shown to reduce artifacts in 3D, as well as in time-resolved (4D) CBCT through the use of projection- and/or volume-domain optimizations, or by introducing neural networks directly within the CBCT reconstruction algorithms. Research gaps are identified to suggest avenues for future exploration. One of the key findings of this work is an observed trend towards the use of generative models including GANs and score-based or diffusion models, accompanied with the need for more diverse and open training datasets and simulations.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), Learning and working together towards better health outcomes today have become more complex requiring an investigation on how interprofessional education (IPE) and interprofessional collaboration (IPC) practices could be sustained and further developed. Through a sociomaterial perspective, we can better understand IPE and IPC practices by foregrounding the material aspect of learning and working together and examining its relationship with humans and their interactions. This article aimed to examine existing literature that discusses the application of sociomaterial perspectives in IPE and IPC. A scoping review was conducted following Arksey and O'Malley's framework to explore the extent within the current body of knowledge that discuss how sociomaterial perspective is applied in IPE and IPC practices. A systematic database search was performed in September 2021 to retrieve literature published from 2007 onwards, with forty-three papers meeting the inclusion criteria. These papers included research articles, book chapters, conference papers and commentaries, with the majority originating from Europe. The thematic analysis revealed the following themes: (1) power as a sociomaterial entity shaping IPE and IPC; (2) inclusion of non-health professionals in reimagining IPE and IPC practices, and (3) the critical understanding of sociomateriality. The findings suggest that a sociomaterial perspective can allow for the reimagination of the contemporary and future practices of interprofessionalism.

Patients, service users and carers are now expected to contribute to teaching health and social care students in all professions. This follows policy directives driven by a review of failings in NHS standards for patient involvement in all aspects of health and social care. Patient and carer contributions to interprofessional education hold fast to values for patient/carer-centred care. This article discusses the context to service user and carer involvement in health professions education, drawing on current evidence and with considerations for midwifery students. A case study of a well-established carer's session is presented, drawing on the input of a mother, which was continued online during the pandemic. It was ensured that this important learning was not lost when teaching became remote, relying on technology-enhanced learning methods. These adaptations depend on long-standing patient partnerships between faculty in higher education institutions and patients/carers who must feel safe and trust the teaching context where they contribute to student learning. Effective learning can be maintained in online environments to ensure the patient voice remains central to health professions training.

This article concludes the interprofessional education series published by the Centre for the Advancement of Interprofessional Education Research Subgroup, and considers the lessons that can be learned from experiences of emergency remote teaching during the COVID-19 pandemic. Consideration is given to the practicalities of emergency remote teaching, including its preparation, delivery and proposed outcomes of using online platforms for interprofessional education. The article is written as a guide for others to draw on and includes considerations for future delivery and sustainability of interprofessional education in midwifery practice and other fields of health and social care.

We identified evidence from item response theory (IRT) to examine a German translation of the Interprofessional Facilitation Scale (IPFS). The IPFS was administered to n = 130 mixed-health profession participants in a post-interprofessional education practicum questionnaire. We used IRT analyses to examine the following three aspects of the IPFS: (a) general factor strength, (b) subscale usability, and (c) item bias. First, findings indicate a strong, general factor underlying the IPFS that supports unidimensional interpretations. Second, findings supported IPFS overall reliability, but failed to support subscale reliabilities. Third, item bias assessment using a comparator-French sample (n = 89) indicated insubstantial differences across German and French samples. Taken together, we find sufficient evidence to support the IPFS-German translation's application in IPE contexts and unidimensional interpretations. Subscores are not advisable for interpretation, and future researchers should aim to further inspect potential item bias.

Background: Physicians are currently overwhelmed by administrative tasks and spend very little time in consultations with patients, which hampers health literacy, shared decision-making, and treatment adherence. Objective: This study aims to examine whether digital agents constructed using fast-evolving generative artificial intelligence, such as ChatGPT, have the potential to improve consultations, adherence to treatment, and health literacy. We interviewed patients and physicians to obtain their opinions about 3 digital agents—a silent digital expert, a communicative digital expert, and a digital companion (DC). Methods: We conducted in-depth interviews with 25 patients and 22 physicians from a purposeful sample, with the patients having a wide age range and coming from different educational backgrounds and the physicians having different medical specialties. Transcripts of the interviews were deductively coded using MAXQDA (VERBI Software GmbH) and then summarized according to code and interview before being clustered for interpretation. Results: Statements from patients and physicians were categorized according to three consultation phases: (1) silent and communicative digital experts that are part of the consultation, (2) digital experts that hand over to a DC, and (3) DCs that support patients in the period between consultations. Overall, patients and physicians were open to these forms of digital support but had reservations about all 3 agents. Conclusions: Ultimately, we derived 9 requirements for designing digital agents to support consultations, treatment adherence, and health literacy based on the literature and our qualitative findings.

This study aims to investigate the impact of electrode shape and positioning on skin impedance measurements, with a focus on a specific radiofrequency therapy device developed in-house for treating cutaneous Leishmaniasis. The study involved 22 volunteers of mixed genders, whose skin impedance was measured in the frequency range of 1~MHz to 10~MHz using the device's uniquely shaped, dry-applied electrodes. Additional measurements were conducted to record skin moisture, surface temperature, and personal parameters of the subjects, which were later used in correlation analysis. While the resistivity values from this study were found to be in alignment with those reported in the existing literature, it is positioning of the electrodes that significantly impacted the skin impedance measurements. Correlations were identified between the skin moisture and average phase shift in facial and forearm measurements and between the average magnitude and phase shift depending on the measurement site. Furthermore, a correlation was observed between the Cole series resistances of the facial and forearm skin. The study does not find a significant influence of gender, age, skin color, ethnicity, or Body Mass Index on the impedance measurements within the tested frequency range. This research enhances our understanding of skin impedance measurements using unique electrode designs and contributes to refining the design of radiofrequency therapy systems.

Glenohumeral biomechanics after rotator cuff (RC) tears have not been fully elucidated. This study aimed to investigate the muscle compensatory mechanism in weight-bearing shoulders with RC tears and asses the induced pathomechanics (i.e., glenohumeral translation, joint instability, center of force (CoF), joint reaction force). An experimental, glenohumeral simulator with muscle-mimicking cable system was used to simulate 30° scaption motion. Eight fresh-frozen shoulders were prepared and mounted in the simulator. Specimen-specific scapular anthropometry was used to test six RC tear types, with intact RC serving as the control, and three weight-bearing loads, with the non-weight-bearing condition serving as the control. Glenohumeral translation was calculated using instantaneous helical axis. CoF, muscle forces, and joint reaction forces were measured using force sensors integrated into the simulator. Linear mixed effects models (RC tear type and weight-bearing) with random effects (specimen and sex) were used to assess differences in glenohumeral biomechanics. RC tears did not change the glenohumeral translation (p > 0.05) but shifted the CoF superiorly (p ≤ 0.005). Glenohumeral translation and joint reaction forces increased with increasing weight bearing (p < 0.001). RC and deltoid muscle forces increased with the presence of RC tears (p ≤ 0.046) and increased weight bearing (p ≤ 0.042). The synergistic muscles compensated for the torn RC tendons, and the glenohumeral translation remained comparable to that for the intact RC tendons. However, in RC tears, the more superior CoF was close to where glenoid erosion occurs in RC tear patients with secondary osteoarthritis. These findings underscore the importance of early detection and precise management of RC tears.

Objectives: As there is no ranking designed for schools of Public Health, the aim of this project was to create one. Methods: To design the Public Health Academic Ranking (PHAR), we used the InCites Benchmarking and Analytics™ software and the Web Of Science™ Core Collection database. We collected bibliometric data on 26 schools of Public Health from each continent, between August and September 2022. We included 11 research indicators/scores, covering four criteria (productivity, quality, accessibility for readers, international collaboration), for the period 2017–2021. For the Swiss School of Public Health (SSPH+), a network gathering faculties across different universities, a specific methodology was used, with member-specific research queries. Results: The five top schools of the PHAR were: London School of Hygiene and Tropical Medicine, Public Health Foundation of India, Harvard T.H. Chan School of Public Health, SSPH+, Johns Hopkins Bloomberg School of Public Health. Conclusion: The PHAR allows worldwide bibliometric ordering of schools of Public Health. As this is a pilot project, the results must be taken with caution. This article aims to critically discuss its methodology and future improvements.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), Determining the acting shoulder and muscle forces in vivo is very complex. In this study, we developed a control strategy for a glenohumeral simulator for ex vivo experiments that can mimic physiological glenohumeral motion and overcome the problem of over-actuation. The system includes ten muscle portions actuated via cables to induce upper arm motion in three degrees of freedom, including scapula rotation. A real-time optimizer was implemented to handle the over-actuation of the glenohumeral joint while ensuring a minimum of muscle tension. The functionality of the real-time optimizer was also used to simulate different extents of rotator cuff tears. Joint reaction forces were consistent with in vivo measurements. These results demonstrate the feasibility and added value of implementing a real-time optimizer for using in vivo data to drive a shoulder simulator. Die Bestimmung der wirkenden Schultergelenks- und Muskelkräfte in vivo ist sehr komplex. In dieser Studie wurde eine Kontrollstrategie für einen glenohumeralen Simulator für ex vivo Experimente entwickelt, der die physiologischen glenohumeralen Bewegungen nachahmen und das Problem der Überaktuation lösen kann. Das System umfasst zehn Muskelsegmente, die über Motoren via Kabelzüge angesteuert werden, um die Oberarmbewegung in drei Freiheitsgraden, einschließlich der Skapularotation, zu induzieren. Ein Echtzeit-Optimierer wurde implementiert, um die Überaktuation des Glenohumeralgelenks zu lösen und gleichzeitig eine minimale Muskelvorspannung zu gewährleisten. Die Funktionalität des Echtzeit-Optimierers wurde auch genutzt, um verschiedene Grade von Rotatorenmanschettenrupturen zu simulieren. Die Gelenkreaktionskräfte stimmten mit den in vivo Messungen überein. Diese Ergebnisse zeigen die Machbarkeit und den Mehrwert der Implementierung eines Echtzeit-Optimierers für die Verwendung von in vivo Daten zur Steuerung eines Schultersimulators.

Background: Biomechanical studies of the shoulder often choose an ex vivo approach, especially when investigating the active and passive contribution of individual muscles. Although various simulators of the glenohumeral joint and its muscles have been developed, to date a testing standard has not been established. The objective of this scoping review was to present an overview of methodological and experimental studies describing ex vivo simulators that assess unconstrained, muscular driven shoulder biomechanics. Methods: All studies with ex vivo or mechanical simulation experiments using an unconstrained glenohumeral joint simulator and active components mimicking the muscles were included in this scoping review. Static experiments and humeral motion imposed through an external guide, e.g., a robotic device, were excluded. Results: Nine different glenohumeral simulators were identified in 51 studies after the screening process. We identified four control strategies characterized by: (a) using a primary loader to determine the secondary loaders with constant force ratios; (b) using variable muscle force ratios according to electromyography; (c) calibrating the muscle path profile and control each motor according to this profile; or (d) using muscle optimization. Conclusion: The simulators with the control strategy (b) (n = 1) or (d) (n = 2) appear most promising due to its capability to mimic physiological muscle loads.

Die vorliegende Masterarbeit befasst sich mit der Entwicklung eines Artefakts in Form einer Virtual-Reality-Simulation eines Elektrorollstuhls für Kinder mit Einschränkungen. Dadurch kommt die Technologie der Virtual Reality in Bereich der sonderpädagogischen und inklusiven Bildung zum Einsatz. Ein Gebiet, in welcher der Einsatz der Virtual Reality Technologie, noch wenig erforscht ist. In der Masterarbeit wird untersucht, welche Eigenschaften das Artefakt aufweisen muss, um bei Kindern mit Einschränkung Akzeptanz zu finden und das pädagogische Personal beim Lernprozess zu entlasten. Das Artefakt wurde mithilfe der Software Unity entwickelt und umfasst zwei aufeinander aufbauende Level, die darauf abzielen, den Lernprozess des Elektrorollstuhlfahrens zu fördern. Zur Umsetzung wurde eine Motion-Plattform, ein Head-Mounted Display von HTC und ein Joystick zur Steuerung des virtuellen Elektrorollstuhls verwendet. Zur Beantwortung dieser Frage wurde die prototypische Methode angewendet. Zwei Testläufe wurden durchgeführt, wobei der erste Testlauf dazu diente die Anwendung zu evaluieren und Verbesserungsmöglichkeiten zu identifizieren. Der zweite Testlauf überprüfte die modifizierten Eigenschaften und beantwortete die Forschungsfrage. Die Vivala Stiftung aus Weinfelden fungierte als Partner dieser Masterarbeit. In Zusammenarbeit mit einem Heilpädagogen, sowie mit zwei Kindern mit Celebralparese wurde untersucht, dass die Faktoren Usability/Playability, Narrative/Wirksamkeit und Vergnügen entscheidend sind für die Akzeptanz der Anwendung. Dem hinzuzufügen ist, dass das Artefakt sowie der Immersionseffekt der Virtual Reality Anwendung von den Kindern wie auch vom Heilpädagogen als sehr positiv wahrgenommen wurden. Dies lässt darauf schliessen, dass die Technologie der Virtual Reality im Bereich der sonderpädagogischen und inklusiven Bildung hohes Potenzial aufweist und dadurch neue Forschungsfelder öffnet.

Migration und auch der Bedarf an ausländischen Pflegekräften tragen dazu bei, dass das Überwinden von Sprachbarrieren für eine effiziente und patientenzentrierte Gesundheitskommunikation immer relevanter wird. Maschinelle Übersetzungstools bergen hierfür sowohl ein grosses Potential als auch Risiken. In einer Interviewstudie mit Ärzt:innen und Pflegepersonal in der Schweiz haben wir den Einsatz automatischer Übersetzungstools in der medizinischen Praxis näher untersucht. Die Ergebnisse unserer Studie zeigen, dass solche Tools bereits eingesetzt werden, der Einsatz aber mit Unsicherheit verbunden ist. Wir erläutern in diesem Zusammenhang das Konzept der Machine Translation Literacy, welche den sachkundigen Einsatz von Übersetzungstools definiert und veranschaulichen, warum sie als eine digitale Kompetenz für die mehrsprachige Gesundheitskommunikation von Bedeutung ist.

The talk will address the different digital health literacy instruments currently existing and present their advantages and limitations. The rapid growth in access and use of digital (health) information resources in our society can also be observed among adolescents and children. However, to date no instrument exists that was specifically designed to measure how children and adolescents find, understand, appraise, and use such digital health information and services. The aim of the talk is to provide an overview of digital literacy instruments and present strengths and limitations of existing instruments. One limitation, the self-reported nature of digital health literacy, will be addressed and potential solutions discussed with the audience. The talk will demonstrate the current lack of instruments to measure digital health literacy in children and adolescents, and what this means for child and adolescent public health and the promotion of digital health literacy.

Machine translation (MT) is increasingly tested as a tool to facilitate the communication across languages in health care settings (Dew et al, 2018). However, today we know little about how MT tools are actually used by healthcare professionals and patients. In addition, there are rarely guidelines that would ensure an appropriate use of this technology (Vieira, O’Hagan, & O’Sullivan 2021). This paper will present results from an interview study conducted with Swiss healthcare professionals on their use of MT. It sets out to better understand the potential of MT in healthcare as well as the human value of interpreters in a communication setting in which intercultural and emotional intelligence are of utmost importance. Results of our study suggest that MT tools and human interpreters are deployed for different types of situations which can be distinguished according to their predictability, technical complexity, emotionality, and relational goals. Also, practical aspects like organization and financing of interpreters seem to play a role. While MT can facilitate access to healthcare, the limitations of MT tools also raise some issues. For example, they can lead to additional stress in patients and a loss of time for healthcare staff. Based on our results, we address the co-existence between MT tools and human interpreters from an ethical perspective and derive recommendations for the use of MT in healthcare that can help to ensure an ethical use of this technology.

Digital health interventions (DHIs) are increasingly used to address the health of migrants and ethnic minorities, some of whom have reduced access to health services and worse health outcomes than majority populations. This study aims to give an overview of digital health interventions developed for ethnic or cultural minority and migrant populations, the health problems they address, their effectiveness at the individual level and the degree of participation of target populations during development. We used the methodological approach of the scoping review outlined by Tricco. We found a total of 2248 studies, of which 57 were included, mostly using mobile health technologies, followed by websites, informational videos, text messages and telehealth. Most interventions focused on illness self-management, mental health and wellbeing, followed by pregnancy and overall lifestyle habits. About half did not involve the target population in development and only a minority involved them consistently. The studies we found indicate that the increased involvement of the target population in the development of digital health tools leads to a greater acceptance of their use.

Hintergrund des Themas: Die Digitalisierung im Gesundheitswesen stellt neue Anforderungen an die Bevölkerung und an Gesundheitsfachpersonen. Den Gesundheitsfachpersonen kommt eine zentrale Rolle bei der Stärkung der (digitalen) Gesundheitskompetenz ihrer Patient:innen zu, vorausgesetzt sie verfügen über die nötige professionelle (digitale) Gesundheitskompetenz. Ziel: Ziel dieser Arbeit war es herauszufinden, von welchen Erfahrungen und Herausforderungen Gesundheitsfachpersonen in der Schweiz in Bezug auf ihre professionelle digitale Gesundheitskompetenz, ihren Umgang mit der digitalen Informationsflut und mit digitalen Neuerungen und Kontaktmöglichkeiten berichten. Methode: Im Sommer 2022 fand eine nationale Onlinebefragung zur professionellen Gesundheitskompetenz statt. Insgesamt wurde 1’851 Gesundheitsfachpersonen befragt. In dieser Arbeit wurde eine deskriptive und bivariate Datenanalyse zum Bereich «professionelle digitale Gesundheitskompetenz und digitale Angebote» durchgeführt. Zentrale Ergebnisse: Alle Gesundheitsfachpersonen erreichen im Bereich der professionellen digitalen Gesundheitskompetenz im Durchschnitt 51 von 100 Punkten. Patient:innen bei der Beurteilung der Vertrauenswürdigkeit von digitalen Informationen zu unterstützen, fällt ihnen am schwersten. Gesundheitsfachpersonen haben Mühe im Umgang mit digitalen Neuerungen. Die Studienergebnisse zeigen, dass GFP persönlich gut mit der digitalen Informationsflut zurechtkommen. Schlussfolgerung: Die Ergebnisse zeigen Handlungsbedarf. Es wäre wichtig, die professionelle digitale GK von GFP in der Ausbildung zu verankern und sie durch regelmässige Weiterbildungsangebote nachhaltig zu fördern.

Introduction: In 2009, The Lancet identified climate change as the greatest threat to global health in the 21st century. Understanding the health impact of climate change and extreme weather events is crucial for all health professionals. Vulnerable groups such as pregnant women, young children and the elderly are particularly affected by climate change. For example, pregnant women are at higher risk of mortality from extreme heat because of their limited ability for adaptation. Pregnancy and childbirth can be used to raise awareness of healthy and sustainable lifestyle changes, and those affected are more likely to be accepting. Health professionals are required to develop skills to identify and integrate the health impacts of climate change into their work with clients. At the Zurich University of Applied Sciences (ZHAW), the topic of "Impacts of climate change" on health is rarely included in the curriculum of the bachelor's degree programe in Health. The relevance of the topic has been outlined for the education and training of health professionals and appeals for existing teaching and learning formats to be supplemented by the topics of climate and sustainability. For this reason, an elective module is offered for students of all degree programe (Occupational Therapy, Health Promotion & Prevention, Midwifery, Nursing and Physiotherapy). The issue is particularly important for midwives because they provide care to people in a sensitive phase of their lives in which climate change has a major impact. Course aim: Participants will gain an insight into the structure and implementation of the interprofessional elective module "Climate (Change) & Health" offered in the ZHAW midwifery programe. The aim of the workshop is to stimulate interdisciplinary exchange. It will focus on the following questions What ideas are there for the development of skills in the role of a change agent? What are the challenges in the didactic and methodological preparation of the topic of

Social media posts can be used to explore public perceptions of interprofessional teams and healthcare professionals. The aim of this study was to use social listening technique to explore unfiltered public perceptions of the professionals involved in healthcare teams during the COVID-19 pandemic, in a naturalistic online setting, and to elaborate on the emotional reactions in response to an online social media post. A cross-sectional retrospective review of comments on a specific social media post was conducted between 15 March and 28 April 2020 using summative content analysis. One image that was widely circulated on social media platforms with two questions: 'Who society thinks works at hospital? versus who really works at hospitals?' was selected. Three platforms were searched, Facebook®, Twitter®, and LinkedIn®. Only publicly available posts were included. Out of the initial 40 posts identified, 21 posts which had 1759 comments were analysed and 1576 were included for coding. Of the emerging nine themes, perceptions of who is in the team was the largest (40.5%, n = 639), followed by agreement (23.1%, n = 364) and feeling excluded (16.2%, n = 255). Of emotional expressions, 42.1% were positive and 57.9% negative. The most frequent emotions were frustration (54.4%, n = 857) followed by gratitude (16.3%, n = 257) and relief (15.9%, n = 250). The post brought considerable attention to the role of the interprofessional team and generated many feelings of frustration and exclusion. For this reason, the response to this social media post is very important and not to be overlooked. Healthcare professionals need to work together to strengthen their presence as an interprofessional team, united to deliver safe effective quality care for patients. The current COVID-19 pandemic and the media attention should be taken as an opportunity by the interprofessional community to work together to combat negative media stereotypes. Further research is warranted on public perception

During pregnancy and early parenthood, parents’ strong interest in pediatric health information presents a valuable opportunity to positively impact long-term health-seeking behavior and overall child health. In line with the increasing prevalence of digital transformation, a scoping review was conducted to explore two key aspects: (1) information seeking and use of digital health information among immigrant parents, and (2) associated reasons and factors. The literature search covered the period until July 2022, using Web of Science, MEDLINE, and CINAHL Complete databases. Out of 625 articles, 12 were included, comprising six qualitative, five quantitative studies, and one review. The majority of studies focused on immigrants in North America, primarily from Latin America and Asia. The studies varied in topics and methodologies, making it challenging to draw general conclusions. Nevertheless, while most immigrant parents rely on digital information on child health, they often prefer human sources such as family, friends, or healthcare providers. Trustworthiness and accessibility emerged as critical criteria for health resources. Two focus group discussions, derived from the results of the review, confirmed these findings for migrant mothers in Switzerland.

Background: Unconscious biases are one of the causes of health disparities. Health professionals have prejudices against patients due to their race, gender, or other factors without their conscious knowledge. This review aimed to provide an overview of research on unconscious bias among health professionals and to investigate the biases that exist in different regions of the world, the health professions that are considered, and the research gaps that still exist. Methods: We conducted a scoping review by systematically searching PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and AMED. All records were double-screened and included if they were published between 2011 and 2021. Results: A total of 5186 records were found. After removing duplicates (n = 300), screening titles and abstracts (n = 4210), and full-text screening (n = 695), 87 articles from 81 studies remained. Studies originated from North America (n = 60), Europe (n = 13), and the rest of the world (n = 6), and two studies were of global scope. Racial bias was investigated most frequently (n = 46), followed by gender bias (n = 11), weight bias (n = 10), socio-economic status bias (n = 9), and mental illness bias (n = 7). Most of the studies were conducted by physicians (n = 51) and nurses (n = 20). Other health care professionals were rarely included in these studies. Conclusions: Most studies show that health professionals have an implicit bias. Racial biases among physicians and nurses in the USA are well confirmed. Research is missing on other biases from other regions and other health professions.

Place-making refers to the emotional attachment people have to a place and has been adopted as a concept in occupational science. In this paper, Relph’s perspective on place-making is associated with how place-making has been discussed in occupational science. Relph’s viewpoint serves as a basis for understanding secret hiding places from children’s perspectives. During data collection for a study investigating children’s perceptions of inclusive playgrounds (Wenger et al., Citation2021), secret hiding places were a recurring topic. This paper aims to explore secret hiding places from the children’s perspective, with a special focus on place-making. To accomplish this, a literature review was undertaken and findings combined with data from two previously conducted studies using qualitative content analysis. From the analysis three categories were developed describing the making of secret hiding places, the purpose of secret hiding places, and play occupations that children do in secret hiding places. The findings suggest that place-making can be seen as an occupation of childhood, related to the physical construction of the secret hiding place itself and the formation of attachment to the place through occupations that are shaped by social interactions and result in meaningful experiences.

For children, playing outdoors is a meaningful occupation, and such play is enabled by outdoor playgrounds. As play is a fundamental right for every child, Universal Design is an approach to creating inclusive playgrounds that welcome all children. Yet, research investigating how the physical environment of a playground supports children’s play needs, in terms of play value and inclusion, is largely absent. Therefore, this study aimed to investigate how children’s experiences of the environmental characteristics of outdoor playgrounds add to the understanding of play value and inclusion from a child-centred perspective. Using a meta-ethnography approach, a systematic review of qualitative evidence was conducted, which included 17 studies. The study identified two themes. Theme one describes the understanding of play value from the children’s view, which includes their experiencing and mastering of challenges, creating and shaping of the physical environment, social experiences of playing with or alongside other children, and sense of belonging felt from the welcoming playground atmosphere. Theme two describes how the design of the physical environment of a playground in the sense of the variety of spaces and places, and the variability of designed and non-designed elements, influences play value and inclusion. The line of argument synthesis describes the interrelationship between the physical (variety and variability) and the social environment (inclusion) characteristics of the playground through the socio-spatial element of play value. This study identified the interrelated elements contributing to high play value, and consequently place-making, which can contribute to the understanding of inclusive design for playgrounds.