scholarly journals Pharmacoeconomics and Pharmacodynamic Interactions of Rocuronium and Pancuronium

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
HariSrinivas Shyam Kumar ◽  
Padmaja Durga ◽  
Rama Mohan Pathapati ◽  
Sujith Tumkur Rajashekar ◽  
Pothula Narasimha Reddy ◽  
...  
Keyword(s):  
Relationship Quality ◽  
Neuromuscular Function ◽  
Response Relationship ◽  
Hemodynamic Changes ◽  
Pharmacodynamic Interaction ◽  
Pharmacodynamic Interactions ◽  
The Mean ◽  
Mean Cost ◽  
Maximal Suppression

Background. We evaluated the pharmacodynamic interaction of the combination of pancuronium and Rocuronium by analyzing time-response relationship, quality of intubating conditions, changes in the hemodynamics, and cost effectiveness as compared to individual drugs. Methods. Sixty patients in the ASA-I category received either 10 ml of 0.9 mg/kg rocuronium (R) plus 10 ml of saline or 10 ml of 0.1 mg/kg pancuronium (P) plus 10 ml of saline or a combination (C) of 10 ml of 0.45 mg/kg R plus 10 ml of 0.05 mg/kg P according to randomization list. Neuromuscular function was measured up to maximal suppression of twitch height. Results. The mean times (sec) taken for twitch height to decrease to 50% of baseline in R, P, and C were 36.84 ± 2.54, 74.60 ± 4.94, and 40.81 ± 2.34, respectively. The mean cost of intubation per patient was 316.71 ± 83.61 INR in group R, 52.30 ± 14.94 INR in group P, and 93.33 ± 20.65 INR in group C. Conclusions. The combination of P and R provides rapid and smooth intubation with minimal hemodynamic changes at a reasonably priced cost.

scholarly journals A COMPARATIVE ANALYSIS OF THE PERFORMANCE OF TRADITIONAL CONTRACTING AND DESIGN-BUILD PROCUREMENTS ON CLIENT OBJECTIVES IN NIGERIA / TRADICINIŲ STATYBOS RANGOS IR PROJEKTAVIMO BEI STATYBOS PIRKIMŲ VYKDYMO, ATSIŽVELGIANT Į UŽSAKOVO TIKSLUS, LYGINAMOJI ANALIZĖ NIGERIJOJE

2011 ◽  
Vol 17 (2) ◽  
pp. 227-233 ◽  
Author(s):  
Stephen Okunlola Ojo ◽  
Omotayo Aina ◽  
Aderemi Yakeen Adeyemi
Keyword(s):  
Quality Standard ◽  
Cost Overrun ◽  
Data Set ◽  
Construction Period ◽  
Design Build ◽  
The Mean ◽  
Using Data ◽  
Building Project ◽  
Mean Cost

Client objectives in a building project are to build within the budget and estimated construction period and being satisfied with the quality of the project. The ability of the procurement methods in achieving these objectives does influence the client to choose any to implement the project. The performance of two of such procurement methods: the traditional contracting and design-build against client objectives were determined using data set of 53 traditional contracts and 15 design-build projects gathered through a questionnaire survey administered unto respondents in three locations in Nigeria. Time overrun, cost overrun and clients’ satisfaction with quality standard were used as basis for comparison. Analysis showed that, the mean cost overrun, and time overrun for design-build were 21.4% and 36.8% respectively as compared with 42.6% and 135.6% for traditional contracting projects. As for quality standard, 78% of design-build clients were satisfied with their projects as compared with 51% for traditional contracting. The overall conclusion is that both methods involve overrun but design-build performed better. Santrauka Užsakovo, vykdančio statybos projektą tikslai – pastatyti statini neviršijant numatyto biudžeto, statybos trukmės ir būti patenkintam projekto kokybe. Pirkimų metodų galimybė pasiekti šiuos tikslus veikia užsakovo sprendimą kurį iš šių metodų pasirinkti ir igyvendinti. Naudojant 53 tradicinių statybos rangos sutarčių ir 15 projektavimo bei statybos sutarčiųduomenis, surinktus apklausų būdu trijuose Nigerijos regionuose, buvo nustatyti du statybos darbų pirkimo vykdymo bū- dai: tradicinis statybos darbų pirkimas ir projektavimo bei statybos pirkimas, atsižvelgiant į užsakovo tikslus. Statybos trukmės viršijimas, kainos viršijimas, pasitenkinimas atliktų darbų kokybe buvo naudojami kaip palyginimų pagrindas. Atlikta analizė parodė, kad vidutinis trukmės ir kainos viršijimas projektavimo ir statybos sutartyse buvo atitinkamai21,4% ir 36,8%, o tradicinėse statybos rangos sutartyse – 42,6% ir 135,6%. 78% projektavimo bei statybos užsakovųbuvo patenkinti atliktų darbų kokybe, o darbus vykdant pagal tradicines sutartis, patenkintųjųdarbų kokybe buvo 51%. Bendra išvada yra ta, kad abiem metodais buvo viršyta trukmė ir kaina, bet taikant projektavimo bei statybos metodą šie rodikliai yra geresni.

The Usefulness of Four Methods of Assessing the Benefits of Electrically Adjustable Beds in Relation to their Costs

1993 ◽  
Vol 9 (4) ◽  
pp. 573-580 ◽  
Author(s):  
Ingrid Söderback ◽  
Anita Lassfolk
Keyword(s):  
Quality Of Life ◽  
The Mean ◽  
Mean Cost ◽  
Worthwhile Investment

AbstractTen picture cards, interviews, time logs, and the Klein-Bell ADL scale were useful in assessing the benefits of electrically adjustable beds to patients but not to caregivers. The mean cost per bed per year of US $346 seems, in relation to the benefits, to be a worthwhile investment for increasing patients' quality of life.

scholarly journals The Economic Burden and Impact on Quality of Life of Herpes Zoster and Postherpetic Neuralgia in Individuals Aged 50 Years or Older in Italy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Sean Matthews ◽  
Antonio De Maria ◽  
Marco Passamonti ◽  
Giovanni Ristori ◽  
Idalba Loiacono ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Herpes Zoster ◽  
Pain Score ◽  
Resource Utilization ◽  
Postherpetic Neuralgia ◽  
Health Care Resource ◽  
The Mean ◽  
Mean Cost

Abstract Background To estimate the health care resource utilization, costs, and impact on quality of life (QoL) of herpes zoster (HZ) and postherpetic neuralgia (PHN) in adults aged ≥50 years in Italy. Methods This was a prospective, observational, multicenter, community physician–based surveillance study (NCT01772160) in Italy. Health-related QoL data were collected using the EuroQoL-5 Dimension (EQ-5D) and Zoster Brief Pain Inventory (ZBPI) questionnaires. Both questionnaires were assessed at days 0 (HZ rash onset), 15, 30, 60, and 90 for all patients, and monthly thereafter for patients who developed PHN. Resource utilization was recorded for 3 months post–HZ onset and 9 months for PHN patients. Costs from both payer and societal perspectives were estimated and were composed of direct medical costs (general practitioner/specialist visits, procedures, hospitalizations, medications), work loss by patient/caregiver, and transport costs. Results A total of 391 patients with HZ were included, of whom 40 developed PHN. The mean ZBPI worst pain score was 5.7 at day 0, reducing to 2.6 at day 30 and 0.7 by day 90. Patients with PHN had a mean worst pain score of 5.7 at day 90. We estimated an overall disutility associated with HZ of 0.134. The mean cost per HZ patient from a payer/societal perspective was €153/€298, respectively, and the mean cost per HZ patients who developed PHN was €176/€426, respectively. Conclusions HZ is associated with impaired QoL and substantial health care resource use, highlighting the need for preventive strategies. This could reduce the disease burden for the patient and health care system. ClinicalTrials.gov study registry NCT01772160.

Memperkuat Loyalitas Melalui Kepercayaan, Kepuasan Dan Komitmen Studi Pada Nasabah PT. Bank Cimb Niaga

Liquidity ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Sri Widyastuti
Keyword(s):  
Customer Satisfaction ◽  
Relationship Quality ◽  
Structural Equation Model ◽  
Customer Loyalty ◽  
Structural Equation ◽  
Positive Influence ◽  
Equation Model ◽  
Survey Method ◽  
Branch Office

Customer loyalty is ‘suspected’not been able to optimizationrepetition of transactions, customer recommendation and durability with the establishment relationship quality of the trust, customer satisfaction and commitment. Therefore, research conducted on Bank CIMB Niaga aims to determine the extent of the trust, and commitment to customer satisfaction can increase X-tra and TabunganKU savings customer loyalty. This research is verification and the method of research is explanatory survey method, the sample is 160 customer X-tra and tabunganKU savings in the branch office Bank CIMB Niaga Bintaro. The analytical method used is structural equation model. The results showed loyalty can be achieved with relationship quality for customers through the establishment of trust, and commitment to customer satisfaction, which all three have a positive influence. Therefore, the management of Bank CIMB Niaga need to improve their ability in trust, satisfactionand commitmentwith the bank's customers to become increasingly favored customers.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Quality of ram spermatozoa separated with modified swim up method

2018 ◽  
Vol 33 (2) ◽  
pp. 62-70 ◽  
Author(s):  
A Hossain ◽  
MM Islam ◽  
F Naznin ◽  
RN Ferdousi ◽  
FY Bari ◽  
...  
Keyword(s):  
Semen Quality ◽  
Membrane Integrity ◽  
Quality Parameters ◽  
Fluid Medium ◽  
Normal Morphology ◽  
The Mean ◽  
Mass Activity ◽  
Fresh Semen ◽  
Artificial Vagina

Semen was collected from four rams, using artificial vagina and viability%, motility% and plasma membrane integrity% were measured. Fresh ejaculates (n = 32) were separated by modified swim-up separation using modified human tubal fluid medium. Four fractions of supernatant were collected at 15-minute intervals. The mean volume, mass activity, concentration, motility%, viability%, normal morphology and membrane integrity% (HOST +ve) of fresh semen were 1.0 ± 0.14, 4.1 ± 0.1 × 109 spermatozoa/ml, 85.0 ± 1.3, 89.4 ± 1.0, 85.5 ± 0.7, 84.7 ± 0.5 respectively. There was no significant (P>0.05) difference in fresh semen quality parameters between rams. The motility%, viability% and HOST +ve % of first, second, third and fourth fractions were 53.4 ± 0.5, 68.2 ± 0.3, 74.8 ± 0.3 and 65.5 ± 0.4; 55.5 ± 0.4, 66.2 ± 0.4, 74.5 ± 0.3 and 73.6 ± 0.3 and 66.7 ± 0.5, 66.8 ± 0.5, 65.2 ± 0.4 and 74.7 ± 0.5 respectively. The motility%, viability% and membrane integrity% of separated semen samples differed significantly (P<0.05) between four fractions. The mean motility% and viability% were significantly higher (P<0.05) in third fraction (74.8 ± 0.3%), whereas the mean HOST +ve% was significantly higher (P<0.05) in fourth fraction (74.7 ± 0.5). All quality parameters of separated spermatozoa were significantly (P<0.05) lower than that of fresh semen. The pregnancy rates were higher with fresh semen (71%) in comparison to that of separated sample (57%).Bangl. vet. 2016. Vol. 33, No. 2, 62-70

Development and Validation of a Questionnaire to Assess Parent Reported Quality of Life Pre and Post Vision Therapy in a Population with Autism Spectrum Disorder

2019 ◽  
pp. 195-207
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Social Behavior ◽  
Psychometric Properties ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Visual Behavior ◽  
The Mean ◽  
Vision Therapy

Background: Autism spectrum disorder is characterized in part by atypical behavior in the communication, social, and visual domains. Success in vision therapy is judged not only by changes in optometric findings, but through improvement in quality of life involving communication, social behavior and visual behavior. It would therefore be beneficial to have a validated questionnaire to assess parent reported quality of life pre and post vision therapy specific to patients with autism spectrum disorder. To our knowledge, a questionnaire of this nature has not been previously published in the literature. Methods: Questionnaire items were generated through surveying medical literature based on symptoms in three different categories: visual behavior, social behavior and communication. A pool of 34 questions was developed initially and then with thorough discussion with other experts, a 20-point questionnaire was developed with each item reflected in the construct concept. A draft of 20 questions was then sent to 10 subject experts with clinical experience in the field for more than 20 years, to review the pooled items. Validity and reliability was established prior to assessing the psychometric properties of the ASD/QOL-VT. Prospective observational study was conducted for a duration of 18 months. The study included individuals undergoing vision therapy in the age range of 3 to 15 years who had been diagnosed with ASD. The questionnaire was administered to parents of these children prior to the start of vision therapy. All subjects completed a minimum of 60 vision therapy sessions. The questionnaire was readministered after completing 60 sessions of vision therapy. Results: Cronbach’s alpha value for this questionnaire was 0.93, which reflected very good internal consistency. Factorial analysis yielded four factors with an Eigen value exceeding 1.0 which accounted for 68% variation in the model. The Cronbach alpha value for subscales identified by factorial analysis is 0.97 indicating excellent internal reliability. The mean pre vision therapy social behavior, communication and visual behavior score was 12.0±3.21, 17.07±4.57 and 26.97±6.41 respectively. The mean post vision therapy scores for social behavior, communication and visual behavior was 8.27±4.16, 11.33±5.27 and 17.93±6.52 respectively. On paired t test, the mean difference in score was statistically significant with P<0.001 in all three subcategories. Conclusions: Our study presents the development of a valid and reliable parent questionnaire, the ASD/QOL-VT, that judges communication, social behavior, and visual behavior in autism. Results of the study conducted indicate that vision therapy can result in significant improvements in the quality of life of patients with ASD as judged by their parents. This is evidenced by statistically significant changes in psychometric properties of the ASD/QOL-VT in social behavior, communication and visual behavior.

Hydrocephalus-related quality of life as assessed by children and their caregivers

2020 ◽  
Vol 26 (4) ◽  
pp. 353-363 ◽  
Author(s):  
Kathrin Zimmerman ◽  
Bobby May ◽  
Katherine Barnes ◽  
Anastasia Arynchyna ◽  
Elizabeth N. Alford ◽  
...  
Keyword(s):  
Posttraumatic Stress ◽  
Traumatic Stress ◽  
Pediatric Patients ◽  
Emotional Health ◽  
Social Emotional ◽  
Proxy Report ◽  
Cognitive Health ◽  
The Mean ◽  
Anxiety Depression

OBJECTIVEHydrocephalus is a chronic medical condition that has a significant impact on children and their caregivers. The objective of this study was to measure the quality of life (QOL) of children with hydrocephalus, as assessed by both caregivers and patients.METHODSPediatric patients with hydrocephalus and their caregivers were enrolled during routine neurosurgery clinic visits. The Hydrocephalus Outcomes Questionnaire (HOQ), a report of hydrocephalus-related QOL, was administered to both children with hydrocephalus (self-report) and their caregivers (proxy report about the child). Patients with hydrocephalus also completed measures of anxiety, depression, fatigue, traumatic stress, and headache. Caregivers completed a proxy report of child traumatic stress and a measure of caregiver burden. Demographic information was collected from administration of the Psychosocial Assessment Tool (version 2.0) and from the medical record. Child and caregiver HOQ scores were analyzed and correlated with clinical, demographic, and psychological variables.RESULTSThe mean overall HOQ score (parent assessment of child QOL) was 0.68. HOQ Physical Health, Social-Emotional Health, and Cognitive Health subscore averages were 0.69, 0.73, and 0.54, respectively. The mean overall child self-assessment (cHOQ) score was 0.77, with cHOQ Physical Health, Social-Emotional Health, and Cognitive Health subscore means of 0.84, 0.79, and 0.66, respectively. Thirty-nine dyads were analyzed, in which both a child with hydrocephalus and his or her caregiver completed the cHOQ and HOQ. There was a positive correlation between parent and child scores (p < 0.004 for all subscores). Child scores were consistently higher than parent scores. Variables that showed association with caregiver-assessed QOL in at least one domain included child age, etiology of hydrocephalus, and history of endoscopic third ventriculostomy. There was a significant negative relationship (rho −0.48 to −0.60) between child-reported cHOQ score and child-reported measures of posttraumatic stress, anxiety, depression, and fatigue. There was a similar significant relationship between caregiver report of child’s QOL (HOQ) and caregiver assessment of the child’s posttraumatic stress symptoms as well as their assessment of burden of care (rho = −0.59 and rho = −0.51, respectively). No relationship between parent-reported HOQ and child-reported psychosocial factors was significant. No clinical or demographic variables were associated with child self-assessed cHOQ.CONCLUSIONSPediatric patients with hydrocephalus consistently rate their own QOL higher than their caregivers do. Psychological factors such as anxiety and posttraumatic stress may be associated with lower QOL. These findings warrant further exploration.

Quality Assessment of Health Information about Scaphoid Fracture in Chinese Websites (Preprint)

2019 ◽  
Author(s):  
Yaobin Yin ◽  
Jianguang Ji ◽  
Peng Lu ◽  
Wenyao Zhong ◽  
Liying Sun ◽  
...  
Keyword(s):  
Social Networks ◽  
Health Information ◽  
Search Engines ◽  
Medical Information ◽  
Scaphoid Fracture ◽  
Family Members ◽  
Online Information ◽  
Specific Content ◽  
The Mean

BACKGROUND With online health information becoming increasingly popular among patients and their family members, concerns have been raised about the accuracy from the websites. OBJECTIVE We aimed to evaluate the overall quality of the online information about scaphoid fracture obtained from Chinese websites using the local search engines. METHODS We conducted an online search using the keyword “scaphoid fracture” from the top 5 search engines in China, i.e. Baidu, Shenma, Haosou, Sougou and Bing, and gathered the top ranked websites, which included a total of 120 websites. Among them, 81 websites were kept for further analyses by removing duplicated and unrelated one as well as websites requiring payment. These websites were classified into four categories, including forum/social networks, commercials, academics and physician’s personals. Health information evaluation tool DISCERN and Scaphoid Fracture Specific Content Score (SFSCS) were used to assess the quality of the websites. RESULTS Among the 81 Chinese websites that we studied, commercial websites were the most common one accounting more than half of all websites. The mean DISCERN score of the 81 websites was 25.56 and no website had a score A (ranging from 64 to 80).The mean SFSCS score was 10.04 and no website had a score A (range between 24 and 30). In addition, DISCERN and SFSCS scores from academic and physician’s websites were significantly higher than those from the forum/social networks and commercials. CONCLUSIONS The overall quality of health information obtained from Chinese websites about scaphoid fracture was very low, suggesting that patients and their family members should be aware such deficiency and pay special attentions for the medical information obtained by using the current search engines in China.

Psychotherapeutic components of commercially available virtual reality games (Preprint)

2020 ◽  
Author(s):  
Almira Osmanovic Thunström ◽  
Iris Sarajlic Vuković ◽  
Lilas Ali ◽  
Tomas Larson ◽  
Steinn Steingrimsson
Keyword(s):  
Mental Health ◽  
Virtual Reality ◽  
Mental Health Problems ◽  
Treatment Strategies ◽  
Treatment Method ◽  
Health Problems ◽  
E Learning ◽  
The Mean ◽  
Unique Games

BACKGROUND Immersive virtual reality (VR) games are increasingly becoming part of everyday life. Several studies support immersive VR technology as a treatment method for mental health problems. There is however minimal research into the feasibility, prevalence, and quality of commercially available VR games on commercial platforms as tools for treatment or add on to treatment of mental health problems. OBJECTIVE The aim of this study was to explore the prevalence, feasibility and quality of commercially available games related to psychotherapy on a commercially available platform. METHODS We performed a search for keywords related to diagnosis and treatment strategies of mental health problems. The search was performed during March 27th on STEAM (VR content and gaming platform). A usability scale was used as a tool to look at the interaction and usability of the games, the VR-UI-UX-8. The tool contains 8 statements about usability scored 0-10, 0 indicating “Not at all” and 10 indicating “very much so”. The score ranges from 0-80 with a higher score indicating worse usability. RESULTS In total, 516 hits were found, 371 unique games. After the games were reviewed, 83 games passed the inclusion criteria, were purchased and played. Majority of the games which were excluded were either not connected to mental health, contained violence, adult content or were in other ways irrelevant or inappropriate. The mean score for the games on the VR-UI-UX-8 was 16.5 (standard deviation 15.8) with a range from 0-68. Most relevant and feasible games were found in the search words meditation, mindfulness, and LSD. CONCLUSIONS Commercial platforms hold great potential for VR games with psychotherapeutic components. The platforms are only at the beginning of the development towards serious games, e-learning and psychotherapeutic treatments. Currently the quality and usability for clinical and at home applicability are scarce, but hold great potential.

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