ORCID Profile
0000-0002-4487-4258
Current Organisations
Universitätsklinikum Essen
,
Black Dog Institute
,
University of New England
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Publications
Considering sociotechnical complexity when designing and developing people-centred digital health interventions: A qualitative study (Preprint)
Publisher: JMIR Publications Inc.
Date: 30-06-2022
Abstract: igital health solutions have the potential to transform health delivery and health outcomes. However, the process of building acceptable and sustainable digital health interventions (DHIs) proves an ongoing challenge in a local landscape with complex and diffuse clinical informatics systems, siloed governance arrangements, and the safety of the ‘known’ for clinicians used to existing, often antiquated information systems. ur paper coalesces existing literature on the development of DHIs in complex environments into three themes to provide a framework to consider lessons learnt in the delivery of an anonymised DHI. We highlight the successes and setbacks involved in the development of a person-centred digital health intervention within a complex health care setting for the benefit of future development of DHIs. e conducted qualitative interviews both in person and via telephone with 22 stakeholders involved in the development of the DHI. Three researchers used a thematic analysis to iteratively code interview transcripts and considered the emerging themes within the context of wider literature. e considered the development of a DHIs around three core themes: creating and sustaining aspirational, yet feasible vision the engagement of decision-makers, service users, and service providers and the use of data and flexibility to solve emerging challenges. Our case ex le underscores the importance of these themes. Specifically, the case ex le demonstrated that the engagement of stakeholders and end-users is important, however equally vital is the alignment between ‘co-design’ and ‘build’ phases of technology development. proved a challenging negotiation for the organisation responsible for the intervention. Additionally, the case ex le showed the necessity of balancing novelty and feasibility of vision, which could have been aided by greater technological competence during co-design phases. ur paper provides an empirical consideration of the complexity of designing and developing digital health interventions, with some practical guidance for mitigating this complexity for future DHI development.
Fatigue and sleepiness responses to experimental inflammation and exploratory analysis of the effect of baseline inflammation in healthy humans
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.BBI.2019.10.020
Abstract: Inflammation is believed to be a central mechanism in the pathophysiology of fatigue. While it is likely that dynamic of the fatigue response after an immune challenge relates to the corresponding cytokine release, this lacks evidence. Although both fatigue and sleepiness are strong signals to rest, they constitute distinct symptoms which are not necessarily associated, and sleepiness in relation to inflammation has been rarely investigated. Here, we have assessed the effect of an experimental immune challenge (administration of lipopolysaccharide, LPS) on the development of both fatigue and sleepiness, and the associations between increases in cytokine concentrations, fatigue and sleepiness, in healthy volunteers. In addition, because chronic-low grade inflammation may represent a risk factor for fatigue, we tested whether higher baseline levels of inflammation result in a more pronounced development of cytokine-induced fatigue and sleepiness. Data from four experimental studies was combined, giving a total of 120 subjects (LPS N = 79, 18 (23%) women Placebo N = 69, 12 (17%) women). Administration of LPS resulted in a stronger increase in fatigue and sleepiness compared to the placebo condition, and the development of both fatigue and sleepiness closely paralleled the cytokine responses. In iduals with stronger increases in cytokine concentrations after LPS administration also suffered more from fatigue and sleepiness (N = 75), independent of gender. However, there was no support for the hypothesis that higher baseline inflammatory markers moderated the responses in fatigue or sleepiness after an inflammatory challenge. The results demonstrate a tight connection between the acute inflammatory response and development of both fatigue and sleepiness, and motivates further investigation of the involvement of inflammation in the pathophysiology of central fatigue.
Endotoxin-initiated inflammation reduces testosterone production in men of reproductive age
Publisher: American Physiological Society
Date: 03-2018
DOI: 10.1152/AJPENDO.00279.2017
Abstract: Inflammation, both acute and chronic, is associated with testosterone deficiency, raising the possibility of a direct causal link. One potential trigger for inflammation in obese men is the passage of intestinal bacteria into the circulation due to a breakdown in mucosal barrier integrity. Recently, we hypothesized that this endotoxin exposure may cause androgen deficiency in obese men. To test this hypothesis, we analyzed the relationship between serum levels of lipopolysaccharide-binding protein (LBP), an indirect measure of endotoxin exposure, against male reproductive hormones, inflammatory markers (C-reactive protein, IL-1β, IL-6, TNF-α), and adiposity in 75 men. Adiposity was positively correlated with endotoxin exposure (LBP) and inflammation (C-reactive protein, IL-6) and negatively correlated with testosterone. Furthermore, endotoxemia (LBP) was negatively correlated with serum testosterone but positively correlated with IL-6. Multivariate analysis revealed a significant, negative correlation between serum IL-6 and free testosterone. In a second interventional study, low-dose endotoxin challenge in lean men produced a transient inflammatory response that was followed by a decline in serum testosterone, without changes in LH or FSH, providing further evidence that endotoxin-driven inflammation may result in impaired Leydig cell function.
“A Love–Hate Relationship with What I Do”: Protecting the Mental Health of Animal Care Workers
Publisher: Informa UK Limited
Date: 27-01-2023
Related Organisations
Related Funding Activities
No related grants have been discovered for Sven Benson.