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Recording of heart rate variability (HRV) is a noninvasive and continuous measurement method that allows investigating the autonomic nervous system (ANS) and its reaction to environmental influences. For a precise measurement of HRV data, a carefully chosen study design and environment is required to minimize secondary influences. One major influence to be avoided is movement. However, in the daily routine and for some scientific questions, movement can often not be avoided. If so, a manual or automated method to differentiate between artifacts caused by body movement and the actual psychophysiological effect is needed to ensure the data quality. In this approach, a chest-worn sensor was developed, that measures the heart rate using a single lead ECG and filters the measured change of the HRV caused by movement. Data from an integrated accelerometer is used to detect upper body movements that affect the resting heart rate. The movementcorresponding time stamps are then used to filter the Interbeat Intervals (IBI) accordingly. Functionality and effectiveness of the sensor system have been tested against state-of-the art sports- or clinical devices in varying scenarios. As our test series showed, motion filtering has a decisive effect when motion occurs, two-thirds of all cases showed a significant effect of motion filtering, with small to medium effect sizes for the parameters SD2, SD2/SD1, and SDNN. Thereby, automatic filtering of motion artifacts can help to significantly reduce the need for costly post-processing of distorted data sets. The results show a better data quality of HRV measurement, a method that is commonly used for the investigation of physiological processes in the field of chronic pain, psychology, psychiatry, or sports medicine.

The present study examines connections between patient expectations and health-related quality of life. We explore a key distinction between expectations about general health and expectations for functional improvement. Patients were 1444 individuals with multiple conditions experiencing chronic pain who were seeking treatment at the Gastein Healing Gallery in Böckstein, near Bad Gastein, Austria. In addition to measures of expectations, patients completed measures of pain, mental and physical health, life satisfaction, fatigue, and sleep problems. Structural equation models were used to fit a latent variable model where both expectation variables were used to predict health-related quality of life. Results showed that expectations regarding potential functional improvement resulting from treatments at the Gastein Healing Gallery were associated with improved health-related quality of life. Expectations about general health improvements related to treatment were not associated with health-related quality of life. To facilitate optimal healing, clinicians may decide to emphasize expectations about functional recovery when discussing treatment methods similar to those offered at the Gastein Healing Gallery, and in so doing, health-related quality of life may benefit.

To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM).In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses.The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate.More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

The proportion of adults suffering from hypertension worldwide was estimated at 31.1 % in 2010. The aim of this study was to evaluate the effects of lifestyle changes in patients with arterial hypertension (AH) in primary care.Systematic literature search in the online databases PubMed, Embase, Cochrane and Opengrey. Only randomized controlled trials of the years 2005 to 2017 in German or English were considered.11 studies out of 458 identified references were evaluated. The patient groups investigated were very heterogeneous and underwent different types of intervention. Educating patients about the clinical picture, regular self-measurements of blood pressure, or patient memories of maintaining a healthy lifestyle have been used most frequently.There is a need for further studies focusing on primary care. However, many lifestyle interventions seem to show very good effects in patients with pre-existing AH (secondary prophylaxis), so these measures should form the basis of antihypertensive therapy in all patients with AH. In addition, it is important to maintain advice on a healthy lifestyle during drug therapy.

Person-centered medicine (PCM) with its focus on humanistic-biographical-oriented medicine and integrated, positive-salutogenic health is a central aspect in the patient-physician relationship in general practice. The objective of this analysis is to assess the prevalence and type of research project in academic institutions of general practice in Germany (Ger) and Austria (At) and the thematic priorities of the projects in the areas PCM, health promotion (HP), prevention (PRE) and conventional medicine (CM).A search was conducted (September-December 2015) on the websites of 30 institutes and divisions of general medicine for their current research projects. The retrieved projects were assigned to five categories: PCM, HP, PRE, CM and others. Subsequently, we identified the targeted patient groups of the projects as well as the thematic focus in the categories PCM, HP, PRE and CM with focus on PCM and HP.541 research projects were identified, 452 in Germany and 89 in Austria. Research projects were only included if they were explicitly indicated as research-oriented. Seventy projects addressed PCM aspects, 15 projects HP aspects, 32 projects PRE aspects and 396 projects CM aspects. The most frequently target groups in the categories PCM (24 of 70) and HP (7 of 15) were chronically ill patients. The most common thematic focus in PCM was communication (13 of 70) and in HP, physical activity (6 of 15).The vast majority of research projects investigated conventional medical topics. The percentage of research activities in the field of PCM (13%) or PCM including HP (16%) in Ger and At is below the European average of 20%. From our point of view, PCM and HP need to be implemented to a greater extent in general practice.Die personenzentrierte Medizin (PZM) mit Fokus auf einer humanistisch-biografisch orientierten Medizin und einem erweiterten, positiv-salutogenen Gesundheitsbegriff ist ein zentraler Bestandteil der Arzt-Patienten Beziehung in der Allgemeinmedizin. Ziel dieser Analyse ist es deshalb, Prävalenz und Typ von Forschungsprojekten in universitären Instituten für Allgemeinmedizin in Deutschland (D) und Österreich (Ö) sowie deren thematische Schwerpunkte in den Bereichen PZM, Gesundheitsförderung (GF), Prävention (PRÄ) und konventioneller Medizin (KM) zu erfassen.Es wurde eine Recherche auf den Webseiten von 30 Instituten für Allgemeinmedizin mit dem Fokus auf deren Forschungsprojekten im Zeitraum September–Dezember 2015 durchgeführt. Die erfassten Projekte wurden in die 5 Kategorien PZM, GF, PRÄ, KM und sonstige Themen eingeteilt. Anschließend erfolgte eine Identifikation der Zielgruppen und thematischen Schwerpunkte in den ersten 4 Kategorien, vertieft in den Bereichen PZM und GF.Die Suche ergab insgesamt 541 Forschungsprojekte (FP), 452 in Deutschland und 89 in Österreich. Es wurden nur FP erfasst, die ausdrücklich als solche gekennzeichnet waren. 70 FP untersuchten Aspekte der PZM, 15 FP Aspekte der GF, 32 FP Aspekte der PRÄ und 395 FP Aspekte der konventionellen Medizin. Chronisch kranke Patienten stellten in den beiden Kategorien PZM (24 von 70) und GF (7 von 15) die häufigste Zielgruppe dar. Häufigster thematischer Schwerpunkt der PZM-Projekte war das Thema Kommunikation (13 von 70), bei den GF-Projekten die körperliche Aktivität (6 von 15).Die Mehrzahl der Forschungsprojekte beschäftigt sich mit konventionellen medizinischen Themen. Mit einem Anteil von 13% (PZM) bzw. 16% (PZMGF) liegt die Forschungsaktivität im Bereich PZM bzw. GF in D und Ö unter dem europäischen Durchschnitt von 20%. Um diese Themenbereiche verstärkt in die hausärztliche Versorgung zu integrieren ist es aus unserer Sicht notwendig u. a. die Forschung zu Voraussetzungen und Barrieren von PZM und GF im ärztlichen Alltag in Deutschland und Österreich zu vertiefen.