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Die Bev��lkerung wird immer ��lter, w��hrend die Geburtenraten stagnieren oder sogar sinken. Dieser demographische Wandel in den Industriel��ndern und die damit einhergehende ��beralterung der Menschen ist eine gro��e gesellschaftliche Herausforderung des 21. Jahrhunderts. Das Gesundheitssystem setzt daher vermehrt auf die medizinische Selbstversorgung der Betroffenen, etwa die eigenst��ndige Einnahme der verschriebenen Medikamente oder das regelm����ige Messen von Vitalparametern, um diesen Wandel zu kompensieren. Da dies jedoch insbesondere f��r ��ltere Personen, die vermehrt mit Krankheiten und diversen Alterserscheinungen zu k��mpfen haben, eine nur schwer zu bewerkstelligende Aufgabe ist, kann es, sollten diese T��tigkeiten nicht korrekt und regelm����ig durchgef��hrt werden, zu lebensbedrohlichen Situationen kommen. Mit dieser Arbeit wurde daher ein Erinnerungssystem entwickelt, welches ��lteren Personen bei ihren allt��glichen medizinischen T��tigkeiten assistiert. Mittels audiovisuellen Benachrichtigungen, die ��ber eine LED-Lampe mit integrierten Lautsprechern wiedergegeben werden, werden die BenutzerInnen an das jeweilige Ereignis erinnert und ��ber eine graphische Anwendungsoberfl��che unterst��tzt und angeleitet. Die auf diesem Wege eingegebenen Daten, wie Einnahmezeiten oder Messwerte, werden protokolliert und stehen wiederum f��r sp��tere Detailauswertungen bzw. Nachverfolgungen zur Verf��gung. Um eine hohe Akzeptanz des Prototyps zu erreichen, wurden ProbandInnen aus der Zielgruppe ausgew��hlt und eng in die einzelnen Schritte der Umsetzung miteinbezogen. Zu Beginn wurden die detaillierten Anforderungen mittels Leitfadeninterviews erhoben, auf deren Basis wiederum Skizzen der Benachrichtigungslampe sowie ein Low-Fidelity Papierprototyp entworfen wurden. Diese Artefakte wurden wiederum durch die TeilnehmerInnen evaluiert, die gewonnen Erkenntnisse eingearbeitet und ein High-Fidelity-Prototyp entwickelt. Nach einem weiteren Evaluierungs- und Anpassungs-Zyklus wurde der endg��ltige Prototyp fertiggestellt und in einer einw��chigen Evaluierungsphase getestet. Die Testdurchf��hrung zeigte, dass durch die audiovisuellen Erinnerungen die Abweichungen zu den korrekten Einnahme- bzw. Messzeiten deutlich verringert werden konnten. Zudem standen die erhobenen Daten in einer zentralen und strukturierten Form zur gezielten Weiterverarbeitung zur Verf��gung. Der, f��r die Zielgruppe entworfene Prototyp wurde von den ProbandInnen problemlos angenommen, aufgrund seines Aussehens diskret in die Wohnumgebung integriert und konnte fehlerfrei ��ber die graphische Anwendungsoberfl��che bedient werden. Demnach konnte gezeigt werden, dass mit dem vorgestellten Ansatz die selbstst��ndige medizinische Versorgung der ��lteren Testpersonen verbessert werden konnte., The population of industrialized nations of the world is getting older while the birth rate is stagnating or even declining. This demographic change and the accompanying superannuation of the human race causes one of the largest social challenges of the 21st century. To compensate this transition, the health care system builds on medical self-support of the involved parties, like autonomous intake of prescribed medications or regular measurement of ones vital parameters.However, this is a challenging task for elderly people who have issues with miscellaneous diseases or other signs of age. Furthermore, this could result in life-threatening situations if the assigned duties are not executed correctly.With this thesis a reminder system is introduced to support everyday medical tasks of elderly people. The system notifies the user by audiovisual signals, which are emitted by a LED-lamp with build-in speakers, and supports him through a graphical user interface. The collected data, like intake times or measurements, will be stored and is available for detailed analyses or medical tracings. To reach a high acceptance level, people of the target audience were included during the whole process of development. In the beginning, the requirements were defined by the use of guided interviews. Based on this data, sketches of the reminder-lamp and a low-fidelity paper-prototype were designed. These artifacts were evaluated by the participants and the obtained insights incorporated into the requirements definitions. Moreover, a high-fidelity-prototype was developed, which equally was put through an evaluation process. Eventually, after another iteration the final prototype was completed and trialled one week at the homes of two subjects.This evaluation showed, that audiovisual reminders reduced the time difference between the planned and actual moment of medication intake or measurement execution. Furthermore, the gained data was stored in a central and structured way, ready for further processing. The prototype, especially designed for the target audience, was accepted unproblematically, integrated smoothly into the peoples environments and could be used without further problems through the graphical user interface. According to these findings it could be shown, that the medical self-support of elderly people could be improved by the presented approach.

Background Hypotensive states that require fast stabilisation of blood pressure can occur during anaesthesia. In 1963, the 20:1 mixture of cafedrine/theodrenaline (Akrinor®) was introduced in Germany for use in anaesthesia and emergency medicine in the first-line management of hypotensive states. Though on the market for many years, few pharmacodynamic data are available on this combination net beta-mimetic agent. Aim This study aimed to examine the drug combination in real-life clinical practice and recorded time to 10 % mean arterial blood pressure (MAP) increase and heart rate. Furthermore, potential factors that influence drug effectiveness under anaesthesia were assessed. Methods Data were collected within a standardised anaesthesia protocol. A total of 353 consecutive patients (female/male = 149/204) who received cafedrine/theodrenaline after a drop in MAP ≥ 5 % were included in the study. The time to 10 % increase in MAP, dosage of cafedrine/theodrenaline, volume loading, blood pressure and heart rate were monitored over time. Results Patients were a mean (standard deviation) of 64.4 ± 15.1 years old with a baseline MAP of 82 ± 14 mmHg, which dropped to a mean of 63 ± 10 mmHg during anaesthesia without gender differences. Cafedrine/theodrenaline (1.27 ± 1.0 mg/kg; 64 ± 50 µg/kg) significantly increased MAP (p

Split-half and test-retest reliabilities of heart-rate responses to a baroreceptor manipulation and an orthostatic maneuver were compared between subjects with either normal or elevated blood-pressure. Ten subjects showing elevated resting blood-pressure and 11 normotensive subjects participated in two experimental sessions, each including heart-rate recordings during baroreceptor manipulation and orthostatic challenge. Carotid baroreceptors were manipulated by applying the baroreceptor-specific phase-related external suction (PRES) technique. The orthostatic stimulation procedure (OSP) was a change of body position from lying to standing. Heart rate responses evoked by OSP failed to discriminate significantly between the groups either in the magnitude or the (test/retest) reliability measure. The PRES procedure also failed to discriminate with the conventional magnitude measure, but the reliability measures showed significant differences. Paradoxically, the high-blood-pressure group manifested the higher baroreceptor reliability. The present findings are consistent with the view that operant conditioning produces phasic blood-pressure increases. In this view, blood-pressure increases activate the arterial baroreceptors which, in turn, dampen pain and/or stress sensitivity. Individuals showing high consistency (reliability) in their cardiovascular responses are more likely to learn this form of conditioning, and hence to eventually increase their tonic blood-pressure. High reliability of cardiovascular responses may therefore constitute a risk for hypertension. Aside from such theoretical considerations, the findings indicate that less conventional dependent variables like reliability may be worth exploring in the search for the etiology of essential hypertension, and that, in this search, specificity (relative to baroreceptor function) is more important than the magnitude of the heart-rate changes that are produced.

Cardiovascular responsiveness in the laboratory and in the field was investigated in male students, 40 with borderline hypertensive blood pressure (SBP > 140mmHg and/or DBP > 90mmHg), 17 with mildly elevated blood pressure, and 41 with normotensive blood pressure. The behavioral tests and physically demanding tasks in the laboratory included mental arithmetic, free speech condition, the Cold Pressor Test, upright tilt, climbing stairs, and ergometer exercise. Subsequently, subjects participated in a 24-hour psychophysiological ambulatory monitoring. Borderline hypertensive and normotensive subjects differed in baseline, task, and recovery levels of SBP, DBP, and HR. A laboratory-field comparison showed that some laboratory tasks substantially predicted average daytime blood pressure and heart rate. Measures that were obtained during upright tilt and the stairs test were found to explain a higher portion of criterion variance than psychological tasks, e.g., mental arithmetic. The elevated heart rate (baseline and task level) that was evident in borderline hypertensive subjects in the laboratory disappeared during ambulatory monitoring. This finding suggests differential adaptations to the laboratory.

Praxis der Kinderpsychologie und Kinderpsychiatrie 39 (1990) 7, S. 244-249, Es wird am Beispiel von Lern- und Spielsituationen aufgezeigt, wie im Einzelfall Veränderungen der Kreislaufaktivität zwischen zwei Situationstypen erfasst und auf statistische Signifikanz geprüft werden können. Die Anwendung dieses Verfahrens zeigt auf, dass sich im Gruppenmittel bei 20 leistungsgestörten Kindern mit dem durchschnittlichen Alter von 9,7 Jahren eine Absenkung der Kreislaufaktivität in einer gemeinsamen Lern- und Leistungssituation mit der Mutter oder dem Vater - im Vergleich zu einer gemeinsamen Spielsituation – ergibt. Mit der Kreislauferniedrigung im Gruppenmittel geht eine Verschlechterung der Beziehung zwischen Kind und Bezugsperson einher. Im Einzelfall können jedoch die Kreislaufwerte steigen wie auch sinken. Das Angebot einer positiven Beziehung durch eine positive „Ersatzmutter" in der gleichen Untersuchungssituation zeigte im Einzelfall repilizierbare Erhöhungen, Gleichheit oder Erniedrigung der Kreislaufaktivitätsveränderungen - im Vergleich zur tatsächlichen, eher strafenden familiären Bezugsperson (Mutter oder Vater). Die Ergebnisse legen eine kritische Prüfung der in Anwendung befindlichen Therapiekonzepte bei leistungsgestörten Kindern im Einzelfall nahe. (DIPF/ Orig.), A method is demonstrated for observing and statistically testing changes in cardiovascular activity in single cases between two types of situations, in this case a playing situation and a learning situation. Using this method it could be shown an abasement of cardiovascular activity during a learning situation together with their mother or father - compared to a playing situation - for 20 hyperactive children with learning problems of an average age of 9.7 years. Together with this abasement in cardiovascular activity there was observed a detoriation in the parent child-relation. In the singles cases however it could be observed an abasement or an increasement in cardiovascular activity. When the - often punishing - parent was replaced by a person who built up a positive relation to the child, there could be observed either an increasement or an abasement or no change in cardiovascular activity, the effect being replaiable. The results point up to a critical examination of actual therapeutical concepts for children with learning problems. (DIPF/ Orig.)