Explore the vast range of titles available.

There is currently an explosion of museum and heritage activity across Asia, especially in China, where audience development and public education have been made a government priority area for museums. In some Asian countries such as Singapore and Korea public participation is already well established. As yet, this is little documented and reviewed for a wider audience in Asia and beyond. This practical handbook examines and critiques these developments and asks how best practice can match the specific needs of diverse Asian cultures and societies. Prioritizing, understanding and developing the relationship between museums and their users in cultural contexts that may, but often do not prioritize the public is a key challenge for Asian museum professionals at all levels, and for foreign partners of Asian museums also. Bringing together a range of regional examples of innovative practice and new initiatives, written by current practitioners, the book covers shared themes and challenges in museums, galleries, outreach/community projects and heritage sites across Asia.

The German Health Data Utilization Act and the Digital Act aim to enhance health data sharing for health care and research in Germany and beyond while ensuring robust data protection. A key prerequisite is patients' willingness to share their data for primary use (PU), such as medical care, and secondary use (SU), such as research. There is a lack of qualitative research examining patients' perspectives on data sharing under the new legal framework, especially among vulnerable groups, such as those with mental health diseases. This study qualitatively examines the factors influencing German patients' willingness to share their digital health data for PU and SU, exploring similarities and differences between patients with somatic and mental health diseases. In 2024, we conducted 2 focus groups (FGs) with 13 outpatients: 7 with somatic diseases (FG1) and 6 with mental health diseases (FG2). Participants were recruited from a University Hospital in Dresden, Germany, based on predefined criteria. Discussions followed a topic guide with open-ended questions informed by an overview of reviews and pretests. Data were analyzed independently by 2 researchers using Kuckartz's approach. Findings are reported according to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. A total of 10 main categories with 32 subcategories were identified as influencing factors: previous data-sharing experience, individual usefulness for medical care, public benefit, personal and privacy concerns, data security concerns, consent management preferences, technical safety measures, legal and ethical framework conditions and requirements, informational self-determination, and social involvement and influence. Both FGs highlighted individual usefulness and public benefit despite various personal experiences. Concerns about discrimination, stigmatization, and automatic data sharing were more relevant in FG2. Technical safety measures of anonymization and pseudonymization were discussed in detail in FG1, whereas FG2 debated data protection intensively. There were concerns that data protection in Germany could potentially pose a greater health risk than the sharing of personal health data. The category consent management preferences yielded the most statements, but no clear consensus emerged. Social influence and involvement, including family, peers, and health care professionals, were more relevant in FG2. Both FGs explicitly opposed the use of health data by companies such as Google. This study qualitatively compared the perspectives of patients with somatic and mental health diseases. While it revealed similarities, patients with mental health diseases viewed their data as highly sensitive due to experiences of stigmatization and fear of misuse, emphasizing the need for tailored consent management. Involving family, peers, and health care professionals can increase acceptance. Health care professionals and targeted outreach can ensure transparency, raising awareness about data sharing policies to build trust, especially when commercial interests are involved. Knowledge deficits, even among tech-savvy patients, indicate the need for broad and understandable public relations efforts.

Background Extremolytes enable microbes to withstand even the most extreme conditions in nature. Due to their unique protective properties, the small organic molecules, more and more, become high-value active ingredients for the cosmetics and the pharmaceutical industries. While ectoine, the industrial extremolyte flagship, has been successfully commercialized before, an economically viable route to its highly interesting derivative 5-hydroxyectoine (hydroxyectoine) is not existing. Results Here , we demonstrate high-level hydroxyectoine production, using metabolically engineered strains of C. glutamicum that express a codon-optimized, heterologous ectD gene, encoding for ectoine hydroxylase, to convert supplemented ectoine in the presence of sucrose as growth substrate into the desired derivative. Fourteen out of sixteen codon-optimized ectD variants from phylogenetically diverse bacterial and archaeal donors enabled hydroxyectoine production, showing the strategy to work almost regardless of the origin of the gene. The genes from Pseudomonas stutzeri (PST) and Mycobacterium smegmatis (MSM) worked best and enabled hydroxyectoine production up to 97% yield. Metabolic analyses revealed high enrichment of the ectoines inside the cells, which, inter alia , reduced the synthesis of other compatible solutes, including proline and trehalose. After further optimization, C.   glutamicum Ptuf ectD PST achieved a titre of 74 g L −1 hydroxyectoine at 70% selectivity within 12 h, using a simple batch process. In a two-step procedure, hydroxyectoine production from ectoine, previously synthesized fermentatively with C. glutamicum ectABC opt , was successfully achieved without intermediate purification. Conclusions C. glutamicum is a well-known and industrially proven host, allowing the synthesis of commercial products with granted GRAS status, a great benefit for a safe production of hydroxyectoine as active ingredient for cosmetic and pharmaceutical applications. Because ectoine is already available at commercial scale, its use as precursor appears straightforward. In the future, two-step processes might provide hydroxyectoine de novo from sugar.

Accurately measuring the quality of stroke care based on claims data alone is challenging. Traditional outcome metrics, e.g. mortality rates, do not capture the effectiveness of critical stroke care processes. We aimed to develop hybrid quality indicators (QIs) by integrating clinical stroke severity data with claims data. Claims data were linked to patient-level clinical data from 15 hospitals (2017–2020) and harmonized in the Observational Medical Outcome Partnership (OMOP) data model. Inclusion criteria, outcomes and risk factors were developed by medical expert panels. We applied machine learning for modeling the outcomes 30-day-mortality , reinfarction within 90 days , and care degree increase within 180 days . We compared extreme gradient boosting (XGBoost) models with and without the National Institutes of Health Stroke Scale (NIHSS) using Receiver-Operating-Characteristic-Area-Under-the-Curve (ROC-AUC) and Brier Score (BS). Hospitals were ranked according to the impact of each QI using Standardized Mortality Ratios (SMRs). The study included 9,348 ischemic (I63) and 1,554 hemorrhagic (I61) strokes, with NIHSS available for 5,012 patients. For all three outcomes, disease severity as measured by NIHSS was the most important determinant. The predictive power of the hybrid models was higher than that of models based on claims data alone. For SMR, the influence of NIHSS was greater than that of age, the most important variable in the claims data model. The results were consistent between the two entities, different outcomes, and sensitivity analyses. Including NIHSS information alongside claims data improves the risk adjustment of quality indicators.

Patient-generated health data (PGHD) from apps and wearables hold significant potential for enhancing personalised care and medical research. Healthcare professionals (HCPs) are key to its successful adoption, as their attitudes can either support or hinder its integration into clinical practice. This review systematically analysed studies on HCPs’ and researchers’ perspectives on PGHD for clinical and research use. Three databases were searched for articles published between January 2013 and April 2023. Of 246 articles screened, 33 met the inclusion criteria. While most participants viewed PGHD positively, concerns around data security, reliability, and workflow integration persist. Addressing these barriers is essential to maximising PGHD’s benefits for participatory medicine and improved clinical outcomes. The included studies presented medium methodological quality, particularly among quantitative and mixed methods with risks of sampling and nonresponse bias, and often low sample sizes in qualitative studies. However, recurring themes across studies allow a valuable interpretation of the findings.

Background The sharing of health data (HD) remains intensely debated, such as in the context of the European Health Data Space. While HD sharing has great potential, the factors influencing patients’ willingness to share their HD remain unclear. Understanding patients’ perspectives is crucial to enhancing their motivation to share their HD, both with healthcare providers (primary use [PU]) and for purposes unrelated to patient care (secondary use [SU]). Objective This overview of systematic reviews (SRs) synthesizes and qualitatively appraises available research on factors affecting patients’ willingness to share their digital HD for PU and SU. Methods The MEDLINE, Embase, and Scopus literature databases were searched in June 2023, complemented by additional searches, to identify SRs focusing on the determinants of patients’ willingness to share HD published from 2013 to 2023. SRs underwent a multistage screening process using the inclusion and exclusion criteria based on the Population, Concept/Construct, and Context (PCC) framework, followed by data extraction and quality assessment using revised measurement tool to assess systematic reviews (R-AMSTAR2). Factors were categorized through a combined deductive-inductive thematic coding process, considering theories on HD sharing and technology acceptance. Results Eleven SRs published between 2014 and 2021 were included, encompassing 321 articles with diverse study designs. Forty-one influencing factors (labeled as facilitators, barriers and inconsistent for unclassifiable factors) were identified and grouped into 15 main categories: 22 facilitators, nine barriers, and four inconsistent factors for PU and 13 facilitators, six barriers, and six inconsistent factors for SU. The key facilitators for PU and SU included higher education, trust, confidentiality, and transparency. The major barriers for PU and SU were privacy and security concerns. The R-AMSTAR2 overall confidence rating of all SRs was critically low. Conclusion Our findings highlight modifiable and nonmodifiable factors affecting patients’ willingness to share their HD. Policymakers and healthcare providers should focus on modifiable factors such as individual usefulness, public benefit, and privacy and security concerns. High-quality SRs are urgently needed to provide reliable recommendations and to develop a holistic, practical framework. Protocol registration number CRD42023429302

The management of multimorbidity is complex and patients have a high burden of disease. When symptoms of dementia also appear, it becomes even more difficult for patients to cope with their everyday lives and manage their diseases. Home-based telemonitoring may support older patients with multimorbidity and mild cognitive impairment (MCI) in their regular monitoring and self-management. However, to date, there has been no investigation into whether patients with MCI are able to operate a telemonitoring app independently to manage their own diseases. This question has become even more important during the current COVID-19 pandemic to maintain high-quality medical care for this patient group. We examined the following research questions: (1) How do patients with MCI assess the usability of the telemonitoring app? (2) How do patients with MCI assess the range of functions offered by the telemonitoring app? (3) Was there an additional benefit for the patients with MCI in using the telemonitoring app? (4) Were patients with MCI able to use the telemonitoring app independently and without restrictions? (5) To what extent does previous experience with smartphones, tablets, or computers influence the perceived ease of use of the telemonitoring app? We performed a formative evaluation of a telemonitoring app. Therefore, we carried out a qualitative study and conducted guided interviews. All interviews were audio-recorded, transcribed verbatim, and analyzed using the Mayring method of structured content analysis. Twelve patients (8 women, 4 men) were interviewed; they had an average age of 78.7 years (SD 5.6) and an average Mini-Mental State Examination score of 24.5 (SD 1.6). The interviews lasted between 17 and 75 minutes (mean 41.8 minutes, SD 19.4). Nine patients reported that the telemonitoring app was easy to use. All respondents assessed the range of functions as good or adequate. Desired functionalities mainly included more innovative and varied educational material, better fit of the telemonitoring app for specific needs of patients with MCI, and a more individually tailored content. Ten of the 12 patients stated that the telemonitoring app had an additional benefit for them. Most frequently reported benefits included increased feeling of security, appreciation of regular monitoring of vital parameters, and increased independence due to telemonitoring. Eight patients were able to operate the app independently. Participants found the app easy to use regardless of whether they had prior experience with smartphones, tablets, or computers. The majority of examined patients with MCI were capable of operating the telemonitoring app independently. Crucial components in attaining independent use were comprehensive personal support from the start of use and appropriate design features. This study provides initial evidence that patients with MCI could increasingly be considered as a relevant user group of telemonitoring apps.

Most current care models are disease- or symptom-focused and mostly do not account for the individual needs of patients with chronic diseases. The aim of this study was to develop an innovative, evidence-based and expert-based practice model for the management of patients with type 2 diabetes mellitus. An iterative approach was used combining systematic literature search with qualitative methods, including a standardised survey of experts in chronic care (n = 92), an expert workshop of professionals (n = 22) and a multilingual online survey (n = 659). Using three consensus meetings involving researchers, policy makers and experts in chronic care, a limited number of core components and care recommendations was set up to develop a new chronic care model. The developed 'MANAGE CARE MODEL' includes aspects of the health and social care system, resources derived from the living environment, aspects of health promotion and prevention, as well as an expanded understanding of improved outcomes as an integral part of chronic care. The MANAGE CARE MODEL provides guidance for the development and implementation of chronic care programs, regional networks and national strategies. Future research is needed to validate the model as an instrument of regional chronic care management.

Purpose Multimorbidity leads to decreasing health-related quality of life (HRQoL). Telemedicine may help to improve HRQoL. The present study was conducted to show (I) differences in HRQoL and changes in HRQoL over time in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment (MCI) using a telemonitoring application (TMA) and (II) associations between engagement with measurements by study participants using a TMA and changes in their HRQoL. Methods The present feasibility study was part of a longitudinal intervention study. Recruited general practitioners (GPs) enrolled individuals and assigned them to risk groups according to absence/presence of depression and/or MCI. Depression was assessed using the Geriatric Depression Scale (GDS-15), MCI using the Mini-Mental State Examination (MMSE), and HRQoL using the SF-12. The TMA consisted of tablets, software, and measuring devices. Measured vital data were transferred to a care and case manager for monitoring and possible intervention. Results Nine GPs recruited 177 individuals, 97 of whom were included in the HRQoL analysis. Significantly lower physical and mental component summary (PCS/MCS) scores were revealed in study participants with depression, and with both depression and MCI, compared to participants with no mental disorders. PCS scores did not differ between study dates, but MCS scores had significantly increased over time. Participants’ engagement with measurements was significantly associated with an increased MCS score, but not with the PCS score. Discussion Depression and/or MCI are negatively associated with the HRQoL of elderly, multimorbid people using a TMA. Engagement of individuals with vital data measurements via a TMA may increase their mental HRQoL. Mentally impaired people should be closely involved as co-designers and experts in development processes of TMAs to benefit from tailored solutions. An individual’s increased mental HRQoL can be a decisive factor in their engagement with a GP treatment regimen and telemonitoring processes.

Digital media shapes children’s learning experiences at home and in the classroom. Research found that early years are critical for cognitive and behavioral development, and there is an on-going discussion about how to respond to the growing presence of technology in the lives of young children. As technology exposure becomes more prevalent in early childhood education, parents, teachers, and caregivers must decide how young students interact with technological devices and what boundaries to set. In this study, I examined how PK4 teachers used interactive media in the classroom and compared that to the beliefs held by classroom parents regarding interactive media. Previous research found that parents regulate media use at home but are not fully aware of how interactive media is implemented throughout the school day. In this study, I explore parents’ beliefs and expectations of interactive media use within the preschool setting. I observed current interactive media use within the preschool setting and analyzed if it’s use aligned with parents’ beliefs and expectations.I conducted a qualitative case study that utilized a combination of semi-structured interviews and direct observations to address the differing views of incorporating interactive media in the early childhood setting. Twelve preschool parents at one school were interviewed to understand interactive media beliefs and expectations, and three preschool teachers at the same school were interviewed and observed to identify current interactive media implementation. Previous research on technology best practices with young children helped shape the Technology Framework. This framework formulated interactive media domains that were used to assess alignment of parent expectations and current classroom use. For the data analysis process, I utilized a combination of inductive and deductive coding through the NVivo coding platform.I found preschool parents communicated positive views of interactive media use within the preschool setting. Parents described interactive media as a future-facing and learner-supportive tool, and they also emphasized that its role within the PK4 environment should be balanced and complementary to teacher led instruction. Parents’ expectations of classroom media use, according to the seven interactive media domains, were consistent with research-based best practices. Findings then highlighted current classroom media use within each domain. The final findings assessed the alignment between parent expectations and classroom interactive media use. Drawing from the Technology Framework’s interactive media domains, I identified alignment in four interactive media domains: Devices Used, Amount of Time, Student Engagement, and Teacher Engagement. I also identified misalignment in three domains: Programs Used, Subjects Used In, and Subjects Not Used In. I also found that misalignment was driven by limited parent awareness, not conflicting expectations. Parents described trust in the school to make developmentally appropriate decisions about interactive media implementation in the PK4 classroom. They assumed teachers were already enacting safeguards that align with the school’s values. Parents’ trust in the school, therefore, explained this misalignment.There are several implications from my study. First, the school could be clearer with the greater community about technology implementation during the school day. There is a need to address how and why interactive media is used in early childhood that align with previous literature’s best practices. Moreover, I found misalignment between parent expectations and classroom practice in three domains, including unawareness of programs used at school and subjects interactive media was utilized in. Lastly, I identified a high level of institutional trust from parents; however, this trust must be maintained and fostered by the school.