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4. Expectations and limitations of E-learning in General Practice (ELGP)

Author

Vollmar, Horst Christian, Waldmann, Uta-Maria, Sönnichsen, Andreas, and Gensichen, Jochen

Subjects
e-learning, general practice, Delphi-study, implementation, education, Computer applications to medicine. Medical informatics, R858-859.7, Infectious and parasitic diseases, RC109-216
Abstract

E-learning and web-based learning can contribute substantially to the increase of knowledge in general practice. During the first congress of e-learning in general practice (ELGP) in July 2005 we therefore initiated a two-round Delphi-study, aiming to identify expectations and barriers regarding ELGP. We distributed questionnaires to the 60 participants of the congress who were invited experts in the field. The responses were independently analysed by two of the authors (HCV, JG) and were clustered to form 32 theses regarding ELGP. These were then given back to the participants in the second round of the Delphi-process with the objective to express agreement or disagreement. The response-rate was 67 percent (n=40) in the first and 60 percent (n=36) in the second round. The extend of agreement with the theses formed in the first round reached from eight percent (“e-learning is displacing practical teaching and learning”) to 97 percent (“e-learning needs convincing didactical concepts”) in the second round. The agreement was low (28%) with the thesis “e-learning can be financed by pharmaceutical companies” and very high with the theses “e-learning can be an important stimulus in continuous medical education”, “e-learning gets a new focus by blended-learning concepts”, “e-learning needs a strong orientation towards its users”, and “users will have a higher level of media-competence five years from now” (94% each). Chances and impetus of e-learning were rated high, but orientation towards users’ needs and the development of innovative didactical concepts (i.e. blended learning) still need to be optimized. The funding of ELGP free from industrial influence will play a major role in implementation. The experts’ responses in the Delphi-process clearly show that ELGP can contribute substantially to pre- and postgraduate medical education, and therefore should be evaluated in systematic studies.

Published
2006

20. A pragmatic randomised controlled trial referring to a Personalised Self-management SUPport Programme (P-SUP) for persons enrolled in a disease management programme for type 2 diabetes mellitus and/or for coronary heart disease

Author

Konerding, Uwe, Redaèlli, Marcus, Ackermann, Karolin, Altin, Sibel, Appelbaum, Sebastian, Biallas, Bianca, Bödecker, August-Wilhelm, Botzenhardt, Suzan, Chermette, Chloé, Cichocki, Martin, Dapper, Iris, Dehnen, Katja, Funke, Christian, Gawlik, Angeli, Giesen, Lisa, Goetz, Johannes, Graf, Christian, Hagen, Bernd, Heßbrügge, Martina, Höhne, Phillip Hendrick, Kleinert, Jens, Könnecke, Helene, Küppers, Lucas, Kuth, Nicole, Lehmann, Lion, Lendt, Claas, Majjouti, Khalid, Nacak, Yeliz, Neuhausen, Aliza, Pilic, Larisa, Schneider, Lara, Scholl, Maximilian, Simic, Dusan, Sönnichsen, Andreas, Thielmann, Anika, Van der Arend, Ines, Vitinius, Frank, Weltermann, Birgitta, Wild, Dorothea, Wilm, Stefan, and Stock, Stephanie

Published
2021
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32. Safety outcomes of direct oral anticoagulants in older adults with atrial fibrillation: a systematic review and meta-analysis of (subgroup analyses from) randomized controlled trials

Author

Doni, Katharina, primary, Bühn, Stefanie, additional, Weise, Alina, additional, Mann, Nina-Kristin, additional, Hess, Simone, additional, Sönnichsen, Andreas, additional, Salem, Susanna, additional, Pieper, Dawid, additional, Thürmann, Petra, additional, and Mathes, Tim, additional

Published
2023
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41. RETRACTED: Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

Author

Kisielinski, Kai, primary, Hirsch, Oliver, additional, Wagner, Susanne, additional, Wojtasik, Barbara, additional, Funken, Stefan, additional, Klosterhalfen, Bernd, additional, Kanti Manna, Soumen, additional, Prescher, Andreas, additional, Sukul, Pritam, additional, and Sönnichsen, Andreas, additional

Published
2023
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42. Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

Author

Kisielinski, Kai, Hirsch, Oliver, Wagner, Susanne, Wojtasik, Barbara, Funken, Stefan, Klosterhalfen, Bernd, Kanti Manna, Soumen, Prescher, Andreas, Sukul, Pritam, and Sönnichsen, Andreas

Subjects
Public Health, Environmental and Occupational Health
Abstract

BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes.ResultsWe found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = −0.24, 95% CI = −0.38 to −0.11, p < 0.001) and minute ventilation (SMD = −0.72, 95% CI = −0.99 to −0.46, p < 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31–0.96, p < 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03–0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03–0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23–1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32–3.17, p < 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p < 0.006 to p < 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p < 0.001), acne (38%, p < 0.001), skin irritation (36%, p < 0.001), dyspnoea (33%, p < 0.001), heat (26%, p < 0.001), itching (26%, p < 0.001), voice disorder (23%, p < 0.03), and dizziness (5%, p = 0.01).DiscussionMasks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations are shorter than daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES) and down-stream physio-metabolic disfunctions. MIES can have long-term clinical consequences, especially for vulnerable groups. So far, several mask related symptoms may have been misinterpreted as long COVID-19 symptoms. In any case, the possible MIES contrasts with the WHO definition of health.ConclusionFace mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions. In the absence of strong empirical evidence of effectiveness, mask wearing should not be mandated let alone enforced by law.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256694, identifier: PROSPERO 2021 CRD42021256694.

Published
2023

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