Search

Purpose: To give an overview of the multicenter Prostate Cancer Outcomes (PCO) study, involving paper-based and web-based collection of patient-reported outcome measures (PROM) in patients undergoing local treatment for prostate cancer in certified centers in Germany. The PCO study is part of the larger Movember-funded TrueNTH Global Registry. The article reports on the study's design and provides a brief progress report after the first 2 years of data collection. Methods: Prostate cancer centers (PCCs) certified according to German Cancer Society requirements were invited to participate in collecting patient-reported information on symptoms and function before and at least once (at 12 months) after treatment. The data were matched with disease and treatment information. This report describes progress in patient inclusion, response rate, and variations between centers relative to online/paper use, and also data quality, including recruitment variations relative to treatment in the first participating PCCs. Results: PCC participation increased over time; 44 centers had transferred data for 3094 patients at the time of this report. Patient recruitment varied widely across centers. Recruitment was highest among patients undergoing radical prostatectomy. The completeness of the data was good, except for comorbidity information. Conclusions: The PCO study benefits from a quality improvement system first established over 10 years ago, requiring collection and harmonization of a predefined clinical dataset across centers. Nevertheless, establishing a PROM routine requires substantial effort on the part of providers and constant monitoring in order to achieve high-quality data. The findings reported here may be useful for guiding implementation in similar initiatives. [ABSTRACT FROM AUTHOR]

Background: To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients' perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients' preferences on assessing PROMs after ischemic stroke. Methods: A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics. Results: 158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15–30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication. Conclusions: For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care. [ABSTRACT FROM AUTHOR]

Backgound: Headache disorders are not only among the most prevalent, they are also among the most disabling disorders worldwide. This paper investigates the association between headache impact on daily life and the socioeconomic status (SES) of headache sufferers. Methods: Data stem from a random general population sample in Germany. Respondents who reported having headache for at least a year and were aged ≥ 18 years were included in the study. A standardized questionnaire addressing headache and headache treatment was filled in during the face-to-face survey. The impact of headache on daily life was measured using the German version of the Headache Impact Test (HIT-6). Results: Higher headache impact was found in low and medium SES compared to high SES. After adjustment for sociodemographics, headache-related factors (analgesic use, headache duration, headache frequency, migraine diagnosis), depressive symptoms, physical inactivity and obesity, an increased odds ratio of having higher headache impact in low SES compared to high SES was found: OR = 1.83, 95% CI [1.43, 2.23], p =.014. When the interactions "SES*obesity", "SES*depressive symptoms", and "SES*physical inactivity" were added, the results showed a significant interaction effect of "SES*obesity". Obese persons with low SES were 3.64 times more likely to have higher headache impact than non-obese persons with low SES. No significant differences between obese and non-obese persons were found in the medium and high SES groups. Conclusions: SES is an important factor that should not be neglected in headache awareness campaigns and headache treatment. Longitudinal studies are needed in the future to investigate whether lifestyle interventions, such as weight reduction, can help to reduce headache impact in people in lower SES. [ABSTRACT FROM AUTHOR]

The paper reports the results of an exploratory online survey among German, Austrian, and Swiss hospital chaplains (n = 158, response rate 17%) to identify the ethical conflicts they encounter in their work. Respondents indicated that questions surrounding end-of-life care are predominant among the conflicts faced. Chaplains get involved with these conflicts most often through the patients themselves or through nursing staff. Most encounters occur during pastoral care visits rather than in structured forms of ethics consultation such as clinical ethics committees. The results add to the ongoing discussion of chaplains as agents in ethics consultation within healthcare systems as well as their specific role and contribution. [ABSTRACT FROM AUTHOR]

Copyright of ZFA: Zeitschrift für Allgemeinmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Our aim was to provide data regarding uptake of gynecological early detection measures and performance of breast self-examinations among migrant women in Germany. Cross-sectional self-reported data were collected using paper-and-pencil questionnaires. Descriptive analyses, Chi square-tests, and logistic regression were applied. Results were adjusted for educational level. Of 5387 women, 89.9% were autochthonous, 4.1% German resettlers, 2.8% Turkish, 3.1% other migrants. Participation rates regarding cancer screening differed significantly, with the lowest proportion in Turkish migrants (65.0%), resettlers (67.8%), other migrants (68.2%) and autochthonous population (78.2%). No differences in performance of breast self-examinations were detected. When adjusted for education, results indicated only slight changes in the odds to participate in screening irregularly or not at all. Results support existing evidence by showing lower participation rates in cancer screening among migrant women, but there were no differences regarding breast self-examinations. Migrant women form a potential high-risk group for late-stage diagnosis of cervical or breast cancer. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal conditions are a leading contributor to disability worldwide. The treatment of these conditions accounts for 7% of health care costs in Germany and is often provided by physiotherapists. Yet, an overview of the cost-effectiveness of treatments for musculoskeletal conditions offered by physiotherapists is missing. This review aims to provide an overview of full economic evaluations of interventions for musculoskeletal conditions offered by physiotherapists. Methods: We systematically searched for publications in Medline, EconLit, and NHS-EED. Title and abstracts, followed by full texts were screened independently by two authors. We included trial-based full economic evaluations of physiotherapeutic interventions for patients with musculoskeletal conditions and allowed any control group. We extracted participants' information, the setting, the intervention, and details on the economic analyses. We evaluated the quality of the included articles with the Consensus on Health Economic Criteria checklist. Results: We identified 5141 eligible publications and included 83 articles. The articles were based on 78 clinical trials. They addressed conditions of the spine (n = 39), the upper limb (n = 8), the lower limb (n = 30), and some other conditions (n = 6). The most investigated conditions were low back pain (n = 25) and knee and hip osteoarthritis (n = 16). The articles involved 69 comparisons between physiotherapeutic interventions (in which we defined primary interventions) and 81 comparisons in which only one intervention was offered by a physiotherapist. Physiotherapeutic interventions compared to those provided by other health professionals were cheaper and more effective in 43% (18/42) of the comparisons. Ten percent (4/42) of the interventions were dominated. The overall quality of the articles was high. However, the description of delivered interventions varied widely and often lacked details. This limited fair treatment comparisons. Conclusions: High-quality evidence was found for physiotherapeutic interventions to be cost-effective, but the result depends on the patient group, intervention, and control arm. Treatments of knee and back conditions were primarily investigated, highlighting a need for physiotherapeutic cost-effectiveness analyses of less often investigated joints and conditions. The documentation of provided interventions needs improvement to enable clinicians and stakeholders to fairly compare interventions and ultimately adopt cost-effective treatments. Key Points: Several high-quality economic evaluations of physiotherapeutic treatments for the back and knee exist Economic evaluations of other joints are rare Physiotherapeutic interventions are often cost-effective over treatments provided by other health professionals The description of provided interventions in cost-effectiveness analyses needs improvement, to allow fair treatment comparisons [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic further unfolds, it becomes a key theoretical and practical question to identify trajectories of child psychological well-being and to explore risk and resilience factors for developmental adjustment. The current study addressed this research gap by means of an ecological design: A (lockdown)–B (relaxation)–B (relaxation)–A (lockdown). We collected parental reports via online questionnaires over four measurement occasions during the COVID-19 pandemic in Germany (non-probabilistic sample): from the first lockdown (T1—spring 2020, N = 1769) to the following period of relaxation (T2—summer 2020, n = 873; T3—fall 2020, n = 729) on to the second lockdown (T4—winter 2020/21, n = 748). Key measures at T1–T4 were child emotional and behavioral problems as well as hyperactivity, child emotional and family-related well-being, parental strain, and parent–child relationship quality. We found evidence for quadratic growth models. While child problem behaviors (b = 0.32, p < 0.001) and emotional well-being (b = − 0.33, p < 0.001) improved after the first lockdown during subsequent periods of relaxation before worsening again in the second lockdown, child family-related well-being steadily decreased over all four measurement points (T1–T2: p < 0.001; T2–T3: p = 0.045; T3–T4: p = 0.030). Importantly, parental stress emerged as a strong risk factor (ps < 0.11) and the parent–child relationship quality constituted a resilience factor (p = 0.049) for child psychological well-being. These findings have major implications for policies aiming to further child health during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This paper presents results on the intergenerational transmission of interpersonal problems. Ninety-eight German mothers, fathers, and their young adult offspring completed the German version of the Inventory of Interpersonal Problems (IIP-D64), which is conceptually based on the assumption of a circumplex structure of eight interpersonal problems. Model learning and psychodynamic theories were used to formulate assumptions about possible intergenerational similarity and dissimilarity, as well as about effects of family and societal context. The results showed the highest intergenerational correlations for three of the eight interpersonal problems in the IIP-D64, namely nonassertiveness, overly strong accommodation, and self-sacrificing tendencies. Intergenerational similarity was found only for mother-offspring dyads for two other problems: domineering and vindictiveness tendencies. No significant intergenerational similarity was found for coldness, social inhibition, or intrusiveness. In-depth analyses revealed higher similarities in families in which at least one parent had an overall IIP-64 score equal to or more than one standard deviation from the norm sample mean (as opposed to families where both parents had overall IIP-64 scores closer to the normative German mean). The findings are tentatively interpreted as suggesting that intergenerational transmission occurs only for problems on one axis of the interpersonal circumplex, i.e., the agency axis, but not for problems on the communality axis. [ABSTRACT FROM AUTHOR]

This paper focusses on coping strategies employed by children and adolescents with diagnosed short stature, assesses the impact of socio-demographic and clinical characteristics on coping, examines the relationship between coping and health related quality of life (QoL) and investigates the role of coping strategies in mediating the relationship between height and QoL. Coping with a disease (CODI) and quality of life in short stature youth (QoLISSY-QoL) questionnaires were completed by 137 short-statured children and adolescents between 8 and 18 years, participating in the crosssectional European QoLISSY study. Clinical and socio-demographic data were collected to examine differences in coping via variance and regression analyses, associations between CODI and QoLISSY were inspected using correlation and mediation analyses. Most frequently employed coping strategies in the CODI were 'Acceptance' and 'Wishful Thinking', with 'Emotional Reaction' used least. Significant effects of age, diagnosis and treatment status on coping strategies were detected. CODI scales 'Acceptance' and 'Distance' were associated with higher QoLISSY-QoL scores, 'Emotional Reaction' and 'Wishful Thinking' with lower scores. Coping strategies predicted 60 % of the QoLISSY-QoL variance. Relationships between height deviation and QoLISSY-QoL were mediated by the coping strategies of 'Wishful Thinking' and 'Distance'. Findings suggest that coping efforts vary with socio-demographic and clinical characteristics, that protective coping strategies in terms of QoL can be identified and that coping mediates the relationship between short stature and QoL. Future longitudinal research should focus on the adaptive function of coping in relation to QoL over time. [ABSTRACT FROM AUTHOR]

Purpose: Sociodemographic and structural conditions have consequences for the labor market participation of young persons with disabilities (YPWD) in vocational rehabilitation (VR). As the type of program determines the labor market chances, we analyze the processes of selecting active labor market programs (ALMP) in VR. Which factors determine the allocation to (1) programs in general and (2) moreover, the allocation to specific programs? Materials and methods: We conduct logistic (1) and multinomial regression (2) using register data of the German Federal Employment Agency. Besides variables on the micro level, we control for a wide range of structural and organizational influences. The sample comprises VR and employment biographies of 255,009 YPWD accepted to VR between 2010 and 2015. Program participation is restricted to start 180 days after VR acceptance. Results: Sociodemographic factors, like age and the status before entering VR as well as the local apprenticeship market as a structural condition, highly influence the general allocation to ALMP. For the allocation to specific ALMP, sociodemographics (age, education, type of disability, status before entering VR) are highly relevant. Furthermore, structural conditions (regional structure of subsidized vocational training and of the apprenticeship market as well as local work possibilities on a special labor market for PWD) and – to a lesser extent - re-organization processes at the FEA (NEO, VR cohort) are important determinants. Conclusion: (Automatic) paths into VR programs for especially persons with mental disabilities in sheltered workshop are clearly shown. Furthermore, it is somewhat questionable that YPWD participate more often in sheltered workshops in regions where sheltered work possibilities are more common, as well as where NEO was implemented locally; and participate more often in company-external vocational training where VR service providers are commissioned to a greater extent. [ABSTRACT FROM AUTHOR]

Summary: We estimated the short-term impact of fragility fractures on community-dwelling women in five countries. Women with fragility fractures reported significantly more difficulties performing activities of daily living and significantly higher levels of lost productivity and caregiver support than those without fractures; results highlight the multi-country indirect burden of fragility fractures. Introduction: To estimate the impact of fragility fractures on activities of daily living (ADL), productivity loss and caregiver support in women with a recent fragility fracture. Methods: This multi-centre cross-sectional study enrolled community-dwelling women aged ≥ 50 years in South Korea, Spain, Germany, Australia and the United States. The fragility fracture cohort consisted of women with an index fragility fracture in the past 12 months; the fracture free cohort consisted of women with no fracture in the 18 months prior to study enrolment. Study participants completed three validated questionnaires: Lawton Instrumental ADL (IADL), Physical Self-Maintenance Scale (PSMS) and iMTA Productivity Cost Questionnaire (iPCQ). Results: In total, 1,253 participants from 41 sites across the five countries were included. Compared with the fracture free cohorts, fragility fracture cohorts had significantly lower function and were more dependent on support (p < 0.05 in all countries for Lawton IADL, and in South Korea, Spain, Australia and the United States for PSMS), significantly higher hours of paid absenteeism (p < 0.05, Spain, Germany, Australia), significantly higher unpaid lost productivity (p < 0.05, South Korea, Spain, Germany), significantly more days of paid help received in the home (p < 0.05 South Korea, Spain and the United States), and significantly more days of unpaid help from family members or friends (p < 0.05, all countries). Conclusion: In this multi-national study, fragility fractures in community-dwelling ≥ 50 years women were associated with several outcomes indicating higher indirect burden and lower quality of life, including more difficulties performing ADL and higher levels of lost productivity and caregiver support. [ABSTRACT FROM AUTHOR]

Background: Nursing home residents (NHR) show high rates of polypharmacy. The HIOPP-3-iTBX study is the first cRCT on medication optimization in nursing homes (NH) in Germany. The intervention did not result in a reduction of PIM and/or antipsychotics. This analysis looks at structure quality in the HIOPP-3-iTBX study participants. Aims: Evaluation of structure quality as part of a cluster-randomized controlled intervention study. Methods: Structure quality in multiprofessional teams from n = 44 NH (n = 44 NH directors, n = 91 family doctors (FD), and n = 52 pharmacies with n = 62 pharmacists) was assessed using self-designed questionnaires at baseline. Main aspects of the questionnaires related to the qualification of participants, quality management, the medication process and size of the facilities. All completed questionnaires were included. number of PIM/antipsychotics was drawn from the baseline medication analysis in 692 NHR. Data were analyzed by descriptive statistics and mixed model logistic regression. Results: The presence of a nurse with one of the additional qualifications pain nurse or Zertifiziertes Curriculum (Zercur) Geriatrie in the participating NH was associated with a lower risk for the prescription of PIM/antipsychotics. No association between any characteristic in the other participants at baseline was observed. Conclusions and discussion: The results support the known role of nursing qualification in the quality and safety of care. Further studies need to look more closely at how use is made of the additional qualifications within the multiprofessional teams. Perspectively, the results can contribute to the development of quality standards in NH in Germany. [ABSTRACT FROM AUTHOR]

Various studies have shown that immigrant women in comparison to non-immigrant women of the same parity have lower rates of epidural anesthesia (EDA). Data from two studies on immigrant obstetric care in Berlin, Germany were analyzed to answer the following question: What reasons do the medical staff see for the lower rate of EDA in immigrant women? Between May and August 2017, 34 interviews with obstetricians and midwives in four obstetric clinics in Berlin were conducted on the topic of obstetric care for immigrant women. After anonymizing the more than 20 h of interview material, transcripts were coded with MaxQDa and analyzed according to the qualitative content analysis.The quantitative data is from an online survey conducted between May and October 2017, in all but one obstetric clinic in Berlin with obstetricians and midwives. Regarding the research question, 121 questionnaires could be analyzed. In the online survey, (multiple answers were possible), the top reason for a lower rate of EDA given was mostly fear on the part of the immigrant women (64%). A language barrier, which results in logistic and time constrictions, is mentioned as the second most frequent reason (50%). The explorative analysis of the interviews shows that doctors and midwives regard cultural aspects such as different expectations on the birth experience as a reason for a lower EDA rate. Furthermore, within the medical staff the impression persists that in some cases the companion decides on the behalf of the patient about the application of an EDA, which from time to time is against the wish of the immigrant woman giving birth. In the view of the medical staff, the reasons for a lower rate of EDA during birth for immigrant women were varied. On one side, this is attributed to the wishes of the respective women ("demand") but on the other side this can be attributed to the health care system ("supply"). In the case of a language barrier, the "supply" and the access of EDA for immigrant women is limited and can be then shifted to the German-speaking companion to make a decision regarding EDA ("structural deprivation of self-determination"). [ABSTRACT FROM AUTHOR]

Purpose: Quality of life (QoL) has been the subject of increasing interest in oncology. Most examinations of QoL have focused on health-related QoL, while other factors often remain unconsidered. Moreover, QoL questionnaires implicitly assume that the subjective importance of the various QoL domains is identical from one patient to the next. The aim of this study was to analyze QoL in a broader sense, considering the subjective importance of the QoL components. Methods: A sample of 173 male urologic patients was surveyed twice: once while hospitalized (t1) and once again 3 months later (t2). Patients completed the Questions on Life Satisfaction questionnaire (FLZ-M), which includes satisfaction and importance ratings for eight dimensions of QoL. A control group was taken from the general population (n = 477). Results: Health was the most important QoL dimension for both the patient and the general population groups. While satisfaction with health was low in the patient group, the satisfaction ratings of the other seven domains were higher in the patient group than in the general population. The satisfaction with the domain partnership/sexuality showed a significant decline from t1 to t2. Multiple regression analyses showed that the domains health and income contributed most strongly to the global QoL score at t2 in the patient group. Conclusion: Health is not the only relevant category when assessing QoL in cancer patients; social relationships and finances are pertinent as well. Importance ratings contribute to a better understanding of the relevance of the QoL dimensions for the patients. [ABSTRACT FROM AUTHOR]

Background: Presbyopia is the age-related deterioration in the ability to focus on close objects. In order to develop a patient-reported outcome (PRO) instrument to assess near vision functioning, the Near Activity Visual Questionnaire (NAVQ) was adapted to incorporate modern technology (e.g. smartphones) and to be appropriate for use in phakic presbyopia, leading to the development of the NAVQ-Presbyopia (NAVQ-P). Additional single-item instruments of near vision correction independence (NVCI), correction preference (NVCP), and vision satisfaction (NVS) were also developed. The study aimed to evaluate the content validity of the NAVQ-P and additional instruments in individuals with phakic presbyopia. Methods: Participants in the US (n = 15), Germany (n = 10) and France (n = 10) took part in face-to-face, qualitative, cognitive debriefing interviews. Seven healthcare professionals (HCPs) were also interviewed to assess the clinical relevance of the PRO instruments. Interviews started with open-ended qualitative concept elicitation questioning; participants then completed the PRO instruments on an electronic tablet using a "think-aloud" process and were asked about their understanding and relevance of each item, instruction, response scale and recall period. Interviews were conducted in two rounds allowing for modifications between rounds. Results: The participants interpreted the majority of the PRO instruments and recall period correctly and consistently. They were able to select an appropriate response option without difficulty. Minor modifications were made to the PRO instruments based on interview findings. Instruction/item wording was modified to include reference to use of a magnifying glass, in addition to glasses and contact lenses. Two items were added to assess difficulty with precision tasks (e.g. sewing) and taking longer to adjust from distance to near vision. HCPs confirmed the relevance of the concepts being measured for presbyopia and recommended the addition of an item assessing contrast sensitivity. Conclusions: Developed in accordance with the FDA PRO Guidance, the findings support content validity of the NAVQ-P as a suitable, well-understood instrument of relevant near vision functioning concepts in individuals with phakic presbyopia. The NVCI and additional PRO instruments are appropriate to assess near vision correction independence, correction preference, and vision satisfaction. Future work will assess the psychometric properties of the NAVQ-P and additional PRO instruments. [ABSTRACT FROM AUTHOR]

This study examined the prevalence of sexual aggression perpetration and victimization in a sample of 1,172 students (755 female, 417 male) from four universities in Germany. All participants were asked about both victimization by, and perpetration of, sexual aggression since the age of 14 years, using the Sexual Aggression and Victimization Scale (SAV-S). Prevalence rates were established for different coercive strategies, sexual acts, and victim-perpetrator relationships. Both same-sex and opposite-sex victim-perpetrator constellations were examined. The overall victimization rate was 62.1% for women and 37.5% for men. The overall perpetration rate was 17.7% for men and 9.4% for women. Prevalence rates of both victimization and perpetration were higher for participants who had sexual contacts with both opposite-sex and same-sex partners than for participants with exclusively opposite-sex partners. Significant overlap was found between victim and perpetrator status for men and women as well as for participants with only opposite-sex and both opposite-sex and same-sex partners. A disparity between (higher) victimization and (lower) perpetration reports was found for both men and women, suggesting a general underreporting of perpetration rather than a gendered explanation in terms of social desirability or the perception of consent cues. The findings are placed in the international research literature on the prevalence of sexual aggression before and after the #metoo campaign, and their implications for prevention efforts are discussed. [ABSTRACT FROM AUTHOR]

Refugees are at an increased risk of mental health problems and low subjective well-being. Living circumstances in the host country are thought to play a vital role in shaping these health outcomes, which, in turn, are prerequisites for successful integration. Using data from a representative survey of 4325 adult refugees who arrived in Germany between 2013 and 2016, we investigated how different living conditions, especially those subject to integration policies, are associated with psychological distress and life satisfaction using linear regression models. Our findings show that an uncertain legal status, separation from family, and living in refugee housing facilities are related to higher levels of distress and decreased life satisfaction. Being employed, contact to members of the host society, and better host country language skills, by contrast, are related to reduced distress and higher levels of life satisfaction. These associations should inform decision making in a highly contested policy area. [ABSTRACT FROM AUTHOR]

About 84,710 Latin American migrants currently live in Germany. Knowledge about their work situation in relation to their skill level and its association with mental health is limited. Therefore, the aims of this study were to assess the prevalence of working below skill level and its association with the prevalence of distress in Latin Americans living in Germany. This cross-sectional study included a convenience sample of 282 Latin American migrants living in Germany. Participants were recruited by a short online (Facebook, personal contacts) or interview-based questionnaire from November 2015 to April 2016. Questions included skill level, job category (categorized by ISCO 2008 code), socio-demographics, violence at the workplace and distress. The latter was assessed by Goldberg's General Health Questionnaire using a cut-off of 4/5. Descriptive statistics were followed by logistic regression analyses adjusting for potential confounders. About half of the study population reported symptoms of distress (45%). 63% of the population worked below skill level. 12-months prevalence of violence at the workplace was 14%. After adjustment, working below skill level was statistically significantly related to distress (odds ratio 2.80; 95% confidence interval 1.58–4.95). Working below skill level is common in Latin American migrants in Germany and may result in poor psychosocial well-being. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare quality of life (QoL) data from cancer patients in different clinical settings with data from the general population.Methods: A sample of 4020 German cancer patients (1735 inpatients, 1324 outpatients, 961 participants in rehabilitation treatment) was tested with the EORTC QLQ-C30.Results: Compared with the general population, cancer patients reported markedly worse QoL. There were clinically significant differences on all 15 scales of the EORTC QLQ-C30 (except one). For the sum score, averaging across 13 scales, the effect size of the difference between cancer patients and the general population was d = 1.16. Inpatients reported the greatest detriments to QoL, followed by the rehabilitation patients and the outpatients (mean sum scores 68.6, 71.0, and 72.3, respectively, compared with 89.2 in the general population). Mean scores for different groups of cancer sites are given separately for the three settings.Conclusion: The detriments to QoL were stronger than in comparable studies conducted on data from clinical trials. Since these detriments were found in all three settings to a similar degree, health care providers should offer their services not only to inpatients but to outpatients and patients treated in rehabilitation clinics as well. The data can be used for QoL comparisons of assessments from different settings. [ABSTRACT FROM AUTHOR]

Purpose The study examined the performance of the Work Ability Index in predicting rehabilitation measures and disability pensions, sickness absence and unemployment benefits, and work participation among a sample of workers previously receiving sickness absence benefits. Methods Workers aged 40 to 54 years who received sickness absence benefits in 2012 completed the Work Ability Index in 2013. Outcomes were extracted from administrative data records. Results Data for 2149 participants were included (mean age: 47.8 years; 54.4% women). Mean follow-up was 19 months. Work Ability Index scores were poor (7-27 points) in 21% of the participants, and moderate (28-36 points) in 38.4%. In all, 224 rehabilitation measures and 35 disability pensions were approved. Fully adjusted analyses showed increased risk of rehabilitation measures in workers with poor (HR 4.55; 95% CI 3.14-6.60) and moderate scores (HR 2.08; 95% CI 1.43-3.01) compared to workers with good or excellent scores (37-49 points). The risk of a disability pension increased significantly for workers with poor scores (HR 7.78; 95% CI 2.59-23.35). In addition, poor scores were prospectively associated with a longer duration of sickness absence and employment benefits, and fewer employment days and less income from regular employment. Conclusions The Work Ability Index is a potential tool for following up workers who already have an increased risk of permanent work disability due to previous long-term sickness absence. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to test psychometric properties of the Satisfaction with Life Scale (SWLS), to provide normative values, and to analyze associations between life satisfaction and sociodemographic and behavioral data.Methods: A German community sample (n = 9711) with an age range of 18-80 years was surveyed using the SWLS and several other questionnaires. Confirmatory factor analysis (CFA) was used to test the dimensionality of the SWLS. Invariance across gender and age groups was tested with multiple-group CFA. Associations between SWLS, sociodemographic variables, and behavioral variables were tested with ANOVAs.Results: Confirmatory factorial analysis results confirmed that the SWLS is a one-dimensional scale. Measurement invariance across gender was completely confirmed, while concerning age strict measurement invariance was confirmed. The effects of gender and age on satisfaction with life were weak. Satisfaction with life was associated with fatigue (r = - .49), the mental component of quality of life (r = .45), anxiety (r = - .42), dispositional optimism (r = .41), pessimism (r = - .34), sleep quality (r = - .32), and sociodemographic factors such as marital status, income, and occupational status. Non-smokers reported higher life satisfaction than smokers.Conclusions: Because of the good psychometric properties, the SWLS can be recommended for use in epidemiological research. Normative values based on a large community sample are provided. [ABSTRACT FROM AUTHOR]

Purpose: Health-related quality of life (HRQoL) is an important patient-reported outcome in clinical and health research. The EQ-5D-Y assesses child and adolescent HRQoL by five items on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression as well as a visual analogue scale (VAS) on the current health state. This study investigates predictors of self-reported HRQoL according to the EQ-5D-Y in chronically ill children and adolescents using longitudinal data.Methods: Data from the German Kids-CAT study on children and adolescents with asthma, diabetes, and juvenile arthritis gathered over a period of six months were analyzed (n = 310; 7-17 years old; 48% female). Self-, parent-, and pediatrician-reported data were collected from June 2013 to October 2014. Generalized linear mixed models and linear mixed models served to examine effects of socio-demographic as well as disease- and health-specific predictors on the items as well as on the VAS of the EQ-5D-Y.Results: Ceiling effects for the EQ-5D-Y indicated low burden of disease in the analyzed sample. Longitudinal analyses revealed associations between less health complaints and better HRQoL for all investigated HRQoL domains. Further, age- and gender-specific effects, and associations of better disease control, longer duration of the disease and less mental health problems with better HRQoL were found.Conclusions: Subjective health complaints and mental health problems should be considered in the care of children and adolescents with asthma, diabetes, and juvenile arthritis. Future research should suggest administering the items of the EQ-5D-Y with five instead of three response options, and investigate HRQoL over a longer period. [ABSTRACT FROM AUTHOR]

Physical activity is a health relevant factor, particularly in affluent societies where overweight and obesity are increasingly prevalent, even among children. Understanding the development of physical activity patterns in childhood is thus an important issue for health promotion. Following socialization theory, this study describes and explains differences in objectively measured moderate-to-vigorous physical activity (MVPA) in a socially and ethnically mixed sample of 6- to 11-year-old children in Germany. MVPA levels were objectively measured with accelerometers over the course of six consecutive days (Wednesday to Monday). Parents' attitudes and practices as well as the family's socio-economic status (SES) were assessed from the parents via questionnaires. Results indicate that MVPA levels of children vary with gender, but not with age and ethnicity. Moreover, parental SES, parental support for the child's sports activities, parents' own sport activities and the parents' belief in sports' capacities to foster personality development, character building and social integration significantly predict the MVPA level of children. It is concluded that interventions to promote MVPA among children need to take family interactions and lifestyles into account and should address families in socio-economically underprivileged areas. [ABSTRACT FROM AUTHOR]

Diagnosing Autism Spectrum Disorders (ASD) is important throughout the lifespan. The objective was to investigate the transcultural diagnostic validity of the Social Communication Questionnaire (SCQ) in a clinical sample of 451 adults with Intellectual Developmental Disorder (IDD) with and without ASD in Germany, the U.S.A. and Great Britain. Variables associated with higher SCQ sum-scores were higher levels of IDD, male gender, a diagnosis of ASD and the study site (Germany > U.S.A > G.B.). An ROC analysis revealed a cut-score of 13, which resulted in a sensitivity of 0.87 and a specificity of 0.58. It is recommended to adjust the cut-score according to level of IDD and gender. Further research is needed to align diagnostic assignment of ASD across different sites and countries. [ABSTRACT FROM AUTHOR]

Background: Patients with autosomal or X-linked Alport syndrome (AS) with heterozygous mutations in type IV collagen genes have a 1-20 % risk of progressing to end-stage renal disease during their lifetime. We evaluated the long-term renal outcome of patients at risk of progressive disease (chronic kidney disease stages 1-4) with/without nephroprotective therapy. Methods: This was a prospective, non-interventional, observational study which included data from a 4-year follow-up of AS patients with heterozygous mutations whose datasets had been included in an analysis of the 2010 database of the European Alport Registry. Using Kaplan-Meier estimates and logrank tests, we prospectively analyzed the updated datasets of 52 of these patients and 13 new datasets (patients added to the Registry after 2011). The effects of therapy, extrarenal symptoms and inheritance pattern on renal outcome were analyzed. Results: The mean prospective follow-up was 46 ± 10 months, and the mean time on therapy was 8.4 ± 4.4 (median 7; range 2-18) years. The time from the appearance of the first symptom to diagnosis was 8.1 ± 14.2 (range 0-52) years. At the time of starting therapy, 5.4 % of patients had an estimated glomerular filtration rate of <60 ml/min, 67.6 % had proteinuria and 27.0 % had microalbuminuria. Therapeutic strategies included angiotensin-converting enzymer inhibitors (97.1 %), angiotensin receptor antagonists (1 patient), dual therapy (11.8 %) and statins (8.8 %). Among patients included in the prospective dataset, prevented the need for dialysis. Among new patients, no patient at risk for renal failure progressed to the next disease stage after 4 years follow-up; three patients even regressed to a lower stage during therapy. Conclusions: Treatment with blockers of the renin-angiotensin-aldosterone system prevents progressive renal failure in AS patients with heterozygous mutations in the genes causing AS. Considerable numbers of aging AS patients on dialysis may have heterozygous mutations in these genes (present in 1 % of total population) as underlying disease. Hence, greater alertness towards timely diagnosis and therapy has the potential to prevent progressive renal failure in most-if not all-AS patients with heterozygous mutations in the causal genes. [ABSTRACT FROM AUTHOR]

Digital media, especially mobile communication technologies, enable adolescents to explore and experiment with each other with only limited adult control. Conflicts between peers can be easily staged since nearly everybody can be reached at any time under the radar of authorities. Therefore, involvement in conflicts and bullying might depend on how adolescents use and behave online. In the present study, we provide a comprehensive picture of the role aspects of online communication play in long-term involvement in cyberbullying. We focused on a gender-specific perspective, as girls and boys were found to differ not only according to their online communication but also in their cyberbullying involvement. Using a two-wave panel survey of 1817 adolescents between 13 and 17 years (56 % female), we found that girls' cyberbullying involvement (perpetration and victimization) could be traced back to more intensive online social activities and a higher amount of online contact with strangers. In contrast, for boys, only higher exposure to antisocial media content predicted higher levels of victimization over time. The findings indicate that certain patterns of online communication increase the cyberbullying risk over time. However, it needs to be noted that these risk factors vary between girls and boys. [ABSTRACT FROM AUTHOR]

To reduce phenotypic heterogeneity of Autism spectrum disorders (ASD) and add to the current diagnostic discussion this study aimed at identifying clinically meaningful ASD subgroups. Cluster analyses were used to describe empirically derived groups based on the Autism Diagnostic Interview-revised (ADI-R) in a large sample of n = 463 individuals with ASD aged 3-21. Three clusters were observed. Most severely affected individuals regarding all core symptoms were allocated to cluster 2. Cluster 3 comprised moderate symptom severity of social communication impairments (SCI) and less stereotyped repetitive behavior (RRB). Minor SCI and relatively more RRB characterized cluster 1. This study offers support for both, a symptom profile, and a gradient model of ASD within the spectrum due to the sample included. [ABSTRACT FROM AUTHOR]

The article presents a cross-sectional study on adolescents with disabilities in Germany and their sexuality and sexual activities. Topics include adolescents with physical, visual, and hearing impairments coming from special education schools, their level of sexual activity, relationships, and experience of sexual intercourse compared to adolescents without disabilities, and results showing the predictors of sexual intercourse such as increasing age, no disability, and a stable relationship.

Pre-pregnancy overweight and obesity is associated with poor health outcomes for the mother and the child. General population studies suggest that childhood maltreatment is associated with obesity in adulthood. The aim of our study was to examine the association between pre-pregnancy overweight and obesity and a history of childhood abuse or neglect including different stages of severity of abuse and neglect. Three hundred twenty-six normal weight, overweight, or obese pregnant women reported demographic data, height and weight, and general psychological distress at 18-22 weeks of gestation. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Associations were examined using logistic regression analyses and a reference group of normal weight women. Fifty percent reported a history of abuse or neglect. After adjusting for age, education, income, marital status, and the number of previous children, pre-pregnancy overweight and obesity were strongly associated with severe physical abuse (overweight: OR = 8.33, 95 % CI 1.48-47.03; obesity: OR = 6.31, 95 % CI 1.06-37.60). Women with severe physical neglect (OR = 4.25, 95 % CI 1.23-14.74) were at increased risk of pregnancy overweight. We found a dose-response relationship between physical abuse and pre-pregnancy overweight and obesity. Whereas other studies report an association between childhood maltreatment and pre-pregnancy obesity, this is the first study that found an association between childhood maltreatment and pre-pregnancy overweight. Considering the severe health risks of pre-pregnancy overweight and obesity and the long-term consequences of childhood maltreatment, affected women constitute a subgroup with special needs in prenatal care. Further research is needed to improve the understanding of the underlying mechanisms. [ABSTRACT FROM AUTHOR]

This study investigated parenting behaviors of mothers and fathers of clinically anxious preschool children (with or without depressive comorbidity) and healthy comparison children. Studies assessing children from early school age onwards have found that parental control, rejection, and inconsistent discipline are associated with the presence of children's internalizing symptoms/disorders. Despite the scarcity of studies investigating these associations at preschool age, we assumed that findings with older children would also apply to children in this age group. In a cross-sectional study we assessed N = 176 children of preschool age ( M = 5; 2 years) and both of their parents. A diagnostic interview (Preschool Age Psychiatric Assessment) was conducted to determine children's psychiatric diagnoses, yielding the following results: a group of n = 67 children with pure anxiety disorders (AD group), a group of n = 38 children with anxiety disorders with depressive comorbidity (AD/DC group), and a comparison group of n = 71 children without psychiatric disorders. Both parents completed the German extended version of the Alabama Parenting Questionnaire. We evaluated maternal depressive symptoms and children's temperament as further correlates. All variables that differed significantly between groups were entered into multinomial logistic regression analyses to test which variables predict group membership. When comparing each of the two anxiety groups with the comparison group we obtained the following results: (1) Inconsistent paternal discipline and maternal depressive symptoms increased and children's positive affectivity decreased the probability of children of being in the AD group rather than in the comparison group. (2) Maternal overinvolvement, maternal depressive symptoms and children's negative affectivity increased and children's positive affectivity decreased the probability of children of belonging to the AD/DC group rather than to the comparison group. When comparing the two anxiety groups with each other, we found that inconsistent paternal discipline increased and children's negative affectivity decreased the probability of children of being in the AD group rather than in the AD/DC group. The results suggest that paternal parenting behaviors show different associations with internalizing disorders at preschool age than maternal parenting behaviors. This underlines the importance of including fathers in the prevention and treatment of internalizing disorders at preschool age. [ABSTRACT FROM AUTHOR]

Physicians frequently represent the first contact person for victims of intimate partner violence (IPV) within the health care system, yet adequate training to comply with these expectations is frequently not incorporated into graduate and post-graduate medical curricula. We developed the first mandatory university-wide training in Germany for the management of IPV victims focusing on communication and legally admissible documentation. Concurrently, we acquired information about previous experiences, attitudes, and barriers for active inquiry about IPV among medical staff. Ninety one percent of the 825 participants completed pre- and post- training surveys and a subgroup participated in a 6-18 month follow-up. Experience, training, and subjective comfort in asking were the most significant predictors of active inquiry in multivariable analyses. Structural limitations, such as time constraints, language barriers, and lack of safe locations represented the primary barriers for active inquiry. [ABSTRACT FROM AUTHOR]

Although there has been an increasing amount of research conducted on test anxiety in adolescence, little is known about the relation of test anxiety and school engagement. The current study addresses this gap by focusing on the potential gender-specific interplay of test anxiety and school engagement among adolescents, testing the role of parental support and parental pressure as mediators in this association. We performed latent multigroup structural equation modeling on a sample of 7th and 8th graders ( N = 1088; M = 13.7 years; SD = .53) in secondary schools in Brandenburg, Germany. The results suggest that there are gender differences in the interplay of test anxiety, perceived socio-academic parental support and pressure, and school engagement. Whereas girls' school engagement is more centered on the mother figure, for boys both parents seem to play an essential role concerning their school engagement as well as test anxiety. [ABSTRACT FROM AUTHOR]

Caregiver burden is a main outcome domain in caregiver intervention research. A recommended instrument for measuring burden is the Sense of Competence Questionnaire (SCQ). In this study, we evaluated the psychometric properties of the German version of the SCQ with informal caregivers of stroke patients. Baseline data of a randomized controlled trial ( n = 122) and survey data ( n = 76) of caregivers of stroke patients were used. Data were collected at the caregiver's or the care receiver's home or over the telephone. We evaluated the homogeneity, the construct validity, and the clinical validity of the German version and the homogeneity of a new abbreviated version. The homogeneity of the SCQ indicates good reliability (Cronbach's alpha: 0.89). The three-factor structure of the SCQ was mostly confirmed through principal components analyses using oblimin rotation. Clinical validity was supported through correlations between sense of competence and burden ( r = −0.51), depression ( r = −0.52), and care recipient's cognitive function ( r = 0.36). Sixteen items with consistent factor loadings were extracted and proposed as a new abbreviated version of the SCQ (Cronbach's alpha: 0.84). The abbreviated German rendition of the SCQ version that was validated in this study offers a consistent version that can be applied across different languages and among caregivers of stroke survivors or people with dementia. [ABSTRACT FROM AUTHOR]

Purpose: To assess rate of late presentation with HIV in Southwestern Germany and to identify patient characteristics correlated with CD4 nadir. Methods: Patients with primary diagnosis who presented to one of ten participating clinics rated on knowledge and behavior towards HIV testing on a self-developed questionnaire, whereas clinical data was assessed by the physician. Results: 161 patients were included. Risk factors were homosexual (59.5 %) or heterosexual contacts (26.8 %), drug use (2.0 %), migration (3.9 %), or others (7.8 %). 63.5 % had a CD4 T cell count < 350/µl. 52.5, 17.4, and 31.1 % were diagnosed in CDC stadium A, B or C, respectively. 209 disease episodes were reported, from whom 83.7 % had led to the diagnosis of HIV. 75.2 and 68.3 % said to have been well-informed about ways of transmission and testing offerings, respectively, and 20.4 % admitted to have psychologically repressed the possibility of being infected. 48 patients rated their personal behavioral risk as 'high' or 'very high'. Of these, however, only ten had performed at test in the precedent year. Performing a regression analysis, younger age and previous testing were correlated with a higher CD4 T cell nadir ( p = 0.005, and 0.018, resp.). Conclusion: The rate of late presentation in this region was even higher compared to national or European surveys. Most infected patients perceived to have had only a low risk. Several disease episodes did not lead to the initiation of HIV testing by the physician. [ABSTRACT FROM AUTHOR]

The high prevalence of mental health problems (MHP) in childhood and adolescence is a global health challenge of the 21st century. Information about age of onset, persistence and development of MHP in young people is necessary to implement effective prevention and intervention strategies. We describe the design and methods of the longitudinal BELLA study, which investigates developmental trajectories of MHP from childhood into adulthood, their determinants, and the utilisation of mental health services. First results on the developmental course of MHP in children and adolescents are reported over a 6-year period. The BELLA study is the mental health module of the German National Health Interview and Examination Survey for children and adolescents (KiGGS). BELLA examines the mental health and well-being of children and adolescents aged 7-17 years (a representative subsample of KiGGS, n = 2,863 at baseline). Standardised screening measures served to identify MHP at baseline and at follow-ups (1, 2, and 6 years later). Among children and adolescents participating at all measurement points ( n = 1,255), 10 % showed clinically significant MHP at baseline ( n = 130). Over the 6-year period, 74.3 % showed no signs of MHP ( n = 933), 15.5 % had remitted ( n = 194), 2.9 % showed persistent ( n = 36) and 7.3 % acute or recurrent MHP ( n = 92). Overall, MHP were more likely to occur between the age of 7 and 12 and after the age of 19 years. Regarding mental health service use, 33 % of the participants with acute or recurrent MHP ( n = 30) and 63.9 % with persistent MHP used mental health services ( n = 23). Mental health problems in children and adolescents have a high risk to persist into adulthood. In children and adolescents a low rate of mental health service use was observed, even among those with mental health problems. [ABSTRACT FROM AUTHOR]

Background: Tension-type headache and migraine are among the most prevalent chronic disorders in children/adolescents. Data on health care utilization for headache in this age group, however, are sparse. Methods: In 1399 grammar school students (aged 12-19 years) with headache in the last six months in Germany a) the burden of disease for headache (mean intensity, mean frequency in the last three months and PedMIDAS means), b) medical care utilization defined by proportion of students consulting a physician in the last 12 months and/or taking analgetic drugs in the last three months by headache types (migraine and tension-type headache) and by burden of disease were assessed. Results: Primary headache substantially impaired daily living activities in adolescents which was mainly related to migraine. Medical care utilization and drug use, however, was low (consulting a physician: 12.0 %, 95 %-CI = [10.3-13.8]; taking analgetic drugs: 29.9 %, 95 %-CI = [27.5-32.4]) - even among students with severe headache (physician consultation: <35 %; taking analgetic drugs: <63 %). Two thirds of students with any headache and 40 % of those with migraine had neither seen a physician nor used analgetic drugs because of their headache in the preceding 12 months. Conclusions: Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) have been proposed to show greater impairments in implicit than explicit mentalizing. To test this proposition, we developed two comparable naturalistic tasks for a performance-based approximation of implicit and explicit mentalizing in 28 individuals with ASD and 23 matched typically developed (TD) participants. Although both tasks were sensitive to the social impairments of individuals with ASD, implicit mentalizing was not more dysfunctional than explicit mentalizing. In TD participants, performance on the tasks did not correlate with each other, whereas in individuals with ASD they were highly correlated. These findings suggest that implicit and explicit mentalizing processes are separable in typical development. In contrast, in individuals with ASD implicit and explicit mentalizing processes are similarly impaired and closely linked suggesting a lack of developmental specification of these processes in ASD. [ABSTRACT FROM AUTHOR]

Background: Multidimensional tinnitus models describe dysfunctional cognitions as a complicating factor in the process of tinnitus habituation. However, this concept has rarely been investigated in previous research. Purpose: The present study investigated the effects of two cognitive-behavioral treatments on dysfunctional tinnitus-related cognitions in patients with chronic tinnitus. Furthermore, dysfunctional cognitions were examined as possible predictors of the therapeutic effect on tinnitus distress. Method: A total of 128 patients with chronic tinnitus were randomly assigned to either an Internet-delivered guided self-help treatment (Internet-based cognitive-behavioral therapy, ICBT), a conventional face-to-face group therapy (cognitive-behavioral group therapy, GCBT), or an active control group in the form of a web-based discussion forum (DF). To assess tinnitus-related dysfunctional thoughts, the Tinnitus Cognitions Scale (T-Cog) was used at pre- and post-assessment, as well as at the 6- and 12-month follow-up. Results: Multivariate ANOVAs with post hoc tests revealed significant and comparable reductions of dysfunctional tinnitus-related cognitions for both treatments (GCBT and ICBT), which remained stable over a 6- and 12-month period. Negative correlations were found between the catastrophic subscale of the T-Cog and therapy outcome for ICBT, but not for GCBT. This means a higher degree of catastrophic thinking at baseline was associated with lower benefit from ICBT directly after the treatment. Hierarchical regression analysis confirmed catastrophizing as a predictor of poorer therapy outcome regarding emotional tinnitus distress in ICBT. No associations were detected in the follow-up assessments. Conclusion: Both forms of CBT are successful in reducing dysfunctional tinnitus-related cognitions. Catastrophizing significantly predicted a less favorable outcome regarding emotional tinnitus distress in ICBT. Clinical implications of these results are described. Dysfunctional cognitions could be targeted more intensively in therapy and in future research on tinnitus. [ABSTRACT FROM AUTHOR]

Justice sensitivity captures individual differences in the frequency with which injustice is perceived and the intensity of emotional, cognitive, and behavioral reactions to it. Persons with ADHD have been reported to show high justice sensitivity, and a recent study provided evidence for this notion in an adult sample. In 1,235 German 10-to 19-year olds, we measured ADHD symptoms, justice sensitivity from the victim, observer, and perpetrator perspective, the frequency of perceptions of injustice, anxious and angry rejection sensitivity, depressive symptoms, conduct problems, and self-esteem. Participants with ADHD symptoms reported significantly higher victim justice sensitivity, more perceptions of injustice, and higher anxious and angry rejection sensitivity, but significantly lower perpetrator justice sensitivity than controls. In latent path analyses, justice sensitivity as well as rejection sensitivity partially mediated the link between ADHD symptoms and comorbid problems when considered simultaneously. Thus, both justice sensitivity and rejection sensitivity may contribute to explaining the emergence and maintenance of problems typically associated with ADHD symptoms, and should therefore be considered in ADHD therapy. [ABSTRACT FROM AUTHOR]

Abnormal brain oscillatory activity has been found in autism spectrum disorders (ASD) and proposed as a potential biomarker. While several studies have investigated gamma oscillations in ASD, none have examined resting gamma power across multiple brain regions. This study investigated resting gamma power using EEG in 15 boys with ASD and 18 age and intelligence quotient matched typically developing controls. We found a decrease in resting gamma power at right lateral electrodes in ASD. We further explored associations between gamma and ASD severity as measured by the Social Responsiveness Scale (SRS) and found a negative correlation between SRS and gamma power. We believe that our findings give further support of gamma oscillations as a potential biomarker for ASD. [ABSTRACT FROM AUTHOR]

Purpose: Coffee consumption has been reported to decrease oxidative damage in peripheral white blood cells (WBC). However, effects on the level of spontaneous DNA strand breaks, a well established marker of health risk, have not been specifically reported yet. We analyzed the impact of consuming a dark roast coffee blend on the level of spontaneous DNA strand breaks. Methods: Healthy men ( n = 84) were randomized to consume daily for 4 weeks either 750 ml of fresh coffee brew or 750 ml of water, subsequent to a run in washout phase of 4 weeks. The study coffee was a blend providing high amounts of both caffeoylquinic acids (10.18 ± 0.33 mg/g) and the roast product N-methylpyridinium (1.10 ± 0.05 mg/g). Before and after the coffee/water consumption phase, spontaneous strand breaks were determined by comet assay. Results: At baseline, both groups exhibited a similar level of spontaneous DNA strand breaks. In the intervention phase, spontaneous DNA strand breaks slightly increased in the control (water only) group whereas they significantly decreased in the coffee group, leading to a 27 % difference within both arms ( p = 0.0002). Food frequency questionnaires indicated no differences in the overall diet between groups, and mean body weight during the intervention phases remained stable. The consumption of the study coffee substantially lowered the level of spontaneous DNA strand breaks in WBC. Conclusion: We conclude that regular coffee consumption contributes to DNA integrity. [ABSTRACT FROM AUTHOR]

This study examined the self-assessed religiosity and spirituality (R/S) of a representative sample of German physicians in private practice ( n = 414) and how this related to their addressing R/S issues with patients. The majority of physicians (49.3 %) reported a Protestant denomination, with the remainder indicating mainly either Catholic (12.5 %) or none (31.9 %). A significant proportion perceived themselves as either religious (42.8 %) or spiritual (29.0 %). Women were more likely to rate themselves R/S than did men. Women (compared to men) were also somewhat more likely to attend religious services (7.4 vs. 2.1 % at least once a week) and participate in private religious activities (14.9 vs. 13.7 % at least daily), although these differences were not statistically significant. The majority of physicians (67.2 %) never/seldom addressed R/S issues with a typical patient. Physicians with higher self-perceived R/S and more frequent public and private religious activity were much more likely to address R/S issues with patients. Implications for patient care and future research are discussed. [ABSTRACT FROM AUTHOR]

The study aims to evaluate the prevalence of depression and the severity of depressive symptoms among primary care patients, who are high utilizers (HU) of health care resources. A cross-sectional, two-stage design was applied to screen for depression using the Brief Psychiatric Health Questionnaire and the Diagnostic Expert System for Psychiatric Disorders. A total of 38 primary care physicians accredited to practice in Berlin and Potsdam in Germany participated in the study. A total of 1,775 patients participated, 507 were identified as HU, 182 (36 %) of these were depressed compared to 81 (11 %) of the typical utilizers ( p < 0.001). The depression score was higher and acute suicidality was more prevalent in HU than in typical utilizers ( p < 0.001). Our results suggest that HU represent a population with a high prevalence of depression in primary care and should be considered for routine depression screening. [ABSTRACT FROM AUTHOR]

Background: To facilitate the transfer of exercise effects to older adults' everyday life, essential daily life movements (stair climbing and walking on different surfaces) were embedded into the functional movement circle for older adults (FuMoC) -- a systematic balance and resistance training programme supplemented by functional movements. Aims: This study's aim was to consider the feasibility of the FuMoC and to evaluate the effects of this new training programme in a randomised controlled pilot study. Methods: Twenty-one adults aged 60 years and older were randomised into one of two groups. The intervention group (IG; n = 11) trained for 12 weeks in the FuMoC, while the control group (CG; n = 10) maintained their usual activities. The evaluation of feasibility comprised training attendance, realised intensity of load, and perceived exertion. Outcome variables included measures of strength and performance-based tests of mobility-related activities. Results: Training attendance was 86 % and the prescribed intensity of load was realised by the participants in the IG. Physical performance showed significant improvements in the IG in comparison to the CG: an increase of 24 % in the One-Repetition Maximum test in the chest press ( p < 0.05), of 9-13 % in the modified Timed Up and Go test ( p < 0.05), and of 10 % in the Maximal Step Length test ( p < 0.05) was identified. Discussion and conclusion: In conclusion, the FuMoC study was feasible in terms of compliance (training attendance) and the planned exercise regimen (suitable exercises, intensity, and exertion) and showed positive effects on physical performance. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the association of current smoking and nicotine dependence with psychological distress in socially disadvantaged urban areas of Germany and Kazakhstan. Random samples of people living in disadvantaged areas of Berlin, Germany, and Almaty, Kazakhstan, were assessed using the General Health Questionnaire with 28 items and the Fagerström Test for Nicotine Dependence. The association of both current smoking and nicotine dependence with psychological distress was assessed for each sample using linear regression analyses and compared between the two samples calculating t-values for the comparison of B-coefficients. Current smoking was equally associated with psychological distress in both countries, whereas the association of nicotine dependence and psychological distress was only seen for the Kazakh sample and significantly stronger than for the German sample. The results could not be explained by social characteristics. Possibly due to the lack of outpatient community mental health services for the treatment of common mental disorders, nicotine dependence was associated with psychological distress in the disadvantaged area of Kazakhstan. [ABSTRACT FROM AUTHOR]

Objectives: We compared the nutritional status of elderly people living in two different settings (shared-housing arrangements and home-living arrangements). Design: For this secondary analysis, a cross-sectional study was performed. Setting: For the home-living setting, home-dwelling elderly people from Hamburg, Germany who were participants in a prior study were included. For the shared-housing arrangements (SHA) setting, we used baseline data from the WGQual Study. Participants: The sample from the home-living setting comprised patients who were discharged from a geriatric rehabilitation clinic within the six months prior to data collection. The sample from the shared-housing arrangements comprised all residents that lived in SHAs. Measurements: Nutritional status was examined by administering the Mini Nutritional Assessment (MNA). Cognitive status was measured by the Mini Mental State Examination (MMSE). Results: Overall, 142 individuals participated in this study. Statistical analysis showed differences in both overall MNA scores and MNA assessment scores. Significantly more participants from the SHA setting were at risk of malnutrition compared to the home-living setting. Conclusion: Screening and assessment of nutritional status and prevention interventions should be considered in SHA settings. [ABSTRACT FROM AUTHOR]