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Aim\ud To compare social, recreational and independent functioning among persons with psychosis across two geo-cultural contexts, we adapted the well-established Social Functioning Scale (SFS) and translated it into French and Tamil. We present the development and psychometric testing of this adaptation, the SFS-Early Intervention.\ud \ud Methods\ud Sixteen items were added to reflect contemporary youth activities (e.g., online games) and 31 items adapted to enhance applicability and/or include context-specific examples (e.g., ‘church activity’ replaced with ‘religious/spiritual activity’). Psychometric properties and participant feedback were evaluated.\ud \ud Results\ud Test–retest reliability (ICCs) ranged from 0.813 to 0.964. Internal consistency (Cronbach's α) ranged from .749 to .936 across sites and languages. Correlations with original subscales were high. The scale was rated easy to complete and understand.\ud \ud Conclusions\ud The SFS-Early Intervention is a promising patient-reported measure of social, recreational and independent functioning. Our approach shows that conceptually sound existing measures are adaptable to different times and contexts.

Mutations in SOCS1 are frequent in primary mediastinal B-cell lymphoma and classical Hodgkin lymphoma. In the latter, SOCS1 mutations affect the length of the encoded protein (major mutations) and are associated with shorter patient survival. Two independent studies examined the prognostic impact of SOCS1 mutations in diffuse large B-cell lymphoma (DLBCL) and showed differing results. This may be due to the small number of included patients, the heterogeneity of patients' demographics and the distinct treatment schemes in these studies. To overcome the size limitations of these previous studies, we assessed SOCS1 mutations in the RICOVER-60 cohort. The cohort uniformly consists of elderly patients (aged 61-80 years) treated with the CHOP-14 scheme (cyclophosphamide, hydroxydaunorubicin, vincristine, prednisolone at 14-day intervals) with or without an additional rituximab treatment. Patient outcomes were analysed with regard to overall SOCS1 mutation frequency, major and minor mutations and a novel impact-based classifier - against the treatment modalities. Patients harbouring putative pathogenic SOCS1 mutations showed significant reduced overall survival within the CHOP plus rituximab group. Hence, putative pathogenic SOCS1 mutations seem to efface the beneficial effect of the therapeutic CD20 antibody. Comparing published data of whole exome and transcriptome sequencing of a large DLBCL cohort confirmed that predicted deleterious SOCS1 mutations forecast pre-eminent survival in early onset DLBCL. peerReviewed

To test whether duration of untreated psychosis (DUP) 3 months, recommended by the World Health Organization/International Early Psychosis Association, enhances the effects of an extended early intervention service (EEIS) on symptom remission.We examined data from a randomized controlled trial in which patients who received 2 years of treatment in EIS for psychosis were subsequently randomized to either 3 years of EEIS or 3 years of regular care (RC). Using a DUP cut-off ≤ 12 weeks (approximately 3 months), patients were split into two groups. Length of positive, negative and total symptom remission were the outcomes.Patients (N = 217) were mostly male (68%) with schizophrenia spectrum disorder (65%); 108 (50%) received EEIS (58 had DUP ≤12 weeks; 50 had DUP12 weeks). Interaction between treatment condition (EEIS vs. RC) and DUP cut-off ≤ 12 weeks was only significant in multiple linear regression model examining length of negative symptom remission as the outcome (adjusted β = 36.88 [SE = 15.88], t = 2.32, P = 0.02). EEIS patients with DUP ≤12 weeks achieved 25 more weeks of negative symptom remission than EEIS patients with DUP12 weeks.Having a short DUP may be critical in deriving long-term benefits from EIS for psychosis, including EEIS settings. This work empirically supports policy recommendations of reducing DUP3 months.

BACKGROUND Heavy alcohol consumption in individuals with type 2 diabetes mellitus (T2DM) is related to increased risks of diabetes-related micro- and macrovascular complications. Depressive symptoms may be relevant to this relationship, because high depressive symptoms are associated with an increased risk of complications. This study investigated whether the interaction between depressive symptoms and alcohol frequency was positively related to the development of neuropathy, retinopathy, nephropathy, and coronary artery disease (CAD), such that those with high depressive symptoms and high alcohol frequency will be at increased risk of complications. METHODS Data were from five waves of the Evaluation of Diabetes Treatment annual survey including 1413 adults with T2DM in Quebec. Data on alcohol frequency (number of drinking occasions), depressive symptoms, and complications were collected annually. The development of each complication was investigated using multiple logistic regression analysis with generalized estimating equations. RESULTS After adjusting for sociodemographic, lifestyle, and diabetes-related covariates, the interaction between alcohol frequency and depressive symptoms was positively related to the incidence of neuropathy and CAD, such that those with high depressive symptoms who drank the most frequently had the highest risk of neuropathy (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.00-1.04; P = 0.04) and CAD (OR 1.02, 95% CI 1.00-1.04; P = 0.04). This interaction was not significantly related to retinopathy or nephropathy. CONCLUSION Individuals with high depressive symptoms and high alcohol frequency may have a particularly high risk of neuropathy and CAD. Future prevention efforts should examine both alcohol frequency and depressive symptoms when evaluating the risk of complications.

To study if obesity is a risk factor in elderly patients (>60 years) with aggressive B-cell lymphoma, the outcomes of 576 elderly patients treated with rituximab in the RICOVER-60 trial were analysed in a retrospective study with regard to body mass index (BMI) and gender. Of the 576 patients, 1% had low body weight (BMI

Male sex is associated with unfavourable pharmacokinetics and prognosis in elderly patients with diffuse large B-cell lymphoma (DLBCL). We investigated higher rituximab doses for elderly male DLBCL patients. Elderly patients (61-80years) received 6 cycles CHOP-14 (cyclophosphamide, doxorubicin, vincristine and prednisone at 14-day intervals) and were randomized to 8 cycles rituximab (males 500 mg/m(2), females 375 mg/m(2)) every 2 weeks or according to an upfront dose-dense schedule. In 268 (120 females, 148 males) no difference between the standard and the upfront dose-dense rituximab schedule was found (3-year PFS 72% vs. 74%;OS 74% vs. 77%;P=0.651). The 500mg/m(2) dose of rituximab for male patients was associated with serum levels and exposure times slightly better than in females and a male/female hazard ratio of 0.9 for progression-free survival (PFS) and 0.8 for overall survival. For elderly males, 500 mg/m(2) was not more toxic than 375 mg/m(2) rituximab, but improved PFS by 32.5% (P=0.039), with a trend for a (30%) better overall survival (P=0.076) in a planned subgroup analysis adjusting for International Prognostic Index risk factors. We conclude that the higher rituximab dose for elderly male patients abrogated the adverse prognosis of male sex without increasing toxicity. In the era of personalized medicine, sex-specific pharmacokinetics and toxicities should be investigated for all drugs where these parameters impact on outcome.

Objective The objective of this study was to assess the risk of diabetes in older adults with elevated depressive symptoms, prediabetes, or both. Method This study included 4129 participants from the English Longitudinal Study of Ageing. Participants were followed from Wave 2 (2004–2005) to Wave 6 (2012–2013). The 8-item Centre for Epidemiologic Studies Depression (CESD) scale was used to measure depressive symptoms in the past week, which were categorized as no/low, mild, or high. Normal glucose levels and prediabetes were defined using baseline haemoglobin A1c measurements. Incident diagnosed diabetes was reported by participants. Cox regression estimated hazard ratios of incident diabetes associated with depressive symptoms and prediabetes. Results A total of 157 participants were diagnosed with diabetes over a mean of 6.7 years. Relative to participants with normal glucose levels and no/low depressive symptoms at baseline, the adjusted hazard ratios were 0.85 (95% CI 0.40–1.82) and 1.62 (95% CI 0.84–3.15) for those with normal glucose levels and mild depressive symptoms and normal glucose levels and high depressive symptoms. The adjusted hazard ratios for participants with prediabetes and no/low depressive symptoms, mild depressive symptoms, and high depressive symptoms were 4.84 (95% CI 3.08–7.60), 7.17 (95% CI 4.00–12.88), and 7.77 (95% CI 4.33–13.93), respectively. Conclusions Older adults with elevated depressive symptoms and prediabetes have an increased risk of diabetes compared to those with only one of these risk factors. Copyright © 2016 John Wiley & Sons, Ltd.

BACKGROUND Type 2 diabetes (T2D) is associated with limitations in day-to-day functioning and with symptoms of anxiety. Although cross-sectional associations between anxiety and functioning in individuals with T2D have been reported, the temporal dynamics of these associations are unclear. The present study examined the longitudinal cross-lagged associations between anxiety symptoms and functioning in a community sample of individuals with T2D. METHODS Data were from the Evaluation of Diabetes Treatment Study, a community-based observational study of 1691 adults with T2D. Anxiety symptoms and functioning were assessed with the Generalized Anxiety Disorder Scale-7 and the World Health Organization Disability Assessment Schedule 2.0, respectively, at baseline and every following year for 3 years. A cross-lagged path analysis accounting for autoregressive effects, sociodemographic factors, and health-related covariates was conducted using structural equation modeling. RESULTS The model demonstrated good fit with the data (comparative fit index >0.99, χ62 = 11.44, P = 0.08, root mean square error of approximation = 0.02). Path coefficients indicated that elevated anxiety was associated with subsequent poor functioning (β-values ranging from 0.05 to 0.16; P-values

Aims To determine if longitudinal cyclical relationships exist between depressive symptoms and diabetes distress in people with Type 2 diabetes mellitus. Methods Data were obtained from the Montreal Evaluation of Diabetes Treatment study, a cohort study of 1691 people with Type 2 diabetes mellitus. Depressive symptoms and diabetes distress, measured with the Patient Health Questionnaire and Diabetes Distress Scale, respectively, were assessed at baseline, 1 year and 2 years. A cross-lagged path model analysis with all autoregressive associations was used. Paths and indirect associations were examined. Results All paths in the model were significant. Depressive symptoms were positively associated with diabetes distress across consecutive time points and diabetes distress was positively associated with depressive symptoms across consecutive time points. The association between depressive symptoms at baseline and depressive symptoms at 2 years was mediated by both depressive symptoms and diabetes distress at 1 year. The association between diabetes distress at baseline and diabetes distress at 2 years was also mediated by both depressive symptoms and diabetes distress. Conclusions Depressive symptoms and diabetes distress are cyclically related; results suggest that depressive symptoms influence diabetes distress, which, in turn, influences depressive symptoms. Although many studies focus on the differences between depressive symptoms and diabetes distress, the present study is the first to provide longitudinal evidence that these constructs are cyclically related.

Background The present study examined the association between moderate and severe diabetes distress (DD) and lifestyle behaviors (physical activity, smoking, alcohol consumption) in a community sample of adults with type 2 diabetes mellitus (T2DM). Methods A total of 1971 adults with T2DM were recruited using mixed methods sampling. Participants were considered eligible if they had a doctor diagnosis of T2DM (≤10 years), were insulin naive, aged 40–75 years, and were from Quebec, Canada. Participants provided information on DD, lifestyle behaviors, sociodemographic, and diabetes-related factors. Multinomial logistic regressions examined the association between moderate and severe DD and each lifestyle behavior, according to gender. Effect estimates can be interpreted as probability ratios (PR). Results In females, physical inactivity was associated with an increased likelihood of moderate distress (PR 2.2; 95% confidence interval [CI] 1.49–3.24) and severe distress (PR 1.80; 95% CI 1.00–3.24). In males, only severe distress was associated with physical inactivity (PR 1.92; 95% CI 1.00–3.66). Current smoking was associated with a greater probability of severe distress in males (PR 3.0; 95% CI 1.54–5.84) and females (PR 1.32; 95% CI 0.67–2.60); however this effect was stronger in males. No association was found between alcohol consumption and DD in females. In males, frequent alcohol consumption was associated with a reduced probability of moderate (PR 0.56; 95% CI 0.34–0.91) and severe distress (PR 0.47; 95% CI 0.21–1.06). Conclusions The findings of this study suggest important gender differences in the association between DD and lifestyle behaviors.

Objective Comorbid depression and cardiometabolic abnormalities might represent an important subgroup of depression. The aim of the present study was to evaluate lifestyle and health-related characteristics of individuals with both depressive symptoms and cardiometabolic abnormalities. Methods Data were from the English Longitudinal Study of Ageing. The sample was comprised of 5365 adults aged 50–80 years. High depressive symptoms were based on the eight-item Center for Epidemiologic Studies – Depression scale. Cardiometabolic abnormalities were defined as having ≥3 cardiometabolic risk factors (hypertension, impaired glycemic control, systemic inflammation, low high-density lipoprotein cholesterol, hypertriglyceridemia, and central obesity). Four groups were created based on Center for Epidemiologic Studies – Depression scores and cardiometabolic abnormalities: those with (i) comorbid depressive symptoms and cardiometabolic abnormalities (DCM); (ii) depressive symptoms only (DnoCM); (iii) cardiometabolic abnormalities only; and (iv) neither depressive symptoms nor cardiometabolic abnormalities. Lifestyle and health-related characteristics of the four groups were compared using chi-square tests. A modified Poisson regression analysis was performed to compare the DCM and the DnoCM groups with respect to lifestyle and health-related characteristics. Results Those in the DCM group were significantly less physically active (p = 0.003), had poorer self-rated health (p

Aim Duration of untreated psychosis (DUP) has been associated with negative symptoms in several studies; however, longitudinal findings have been inconsistent. No previous study has accounted for active psychosis after presentation, although this could impact on outcomes in a manner similar to DUP. Methods We measured Scale for the Assessment of Positive Symptoms at frequent intervals during the 12 months after initial presentation to determine the active psychosis duration for 230 individuals with first-episode psychosis. This duration was added to DUP prior to presentation to create a new variable, duration of active psychosis (DAP). Negative symptoms were divided into expressivity and motivation/pleasure domains as measured by Scale for the Assessment of Negative Symptoms (SANS). The relationship of DUP and DAP with negative symptoms at 24-month follow up was determined and confounders controlled for using regression analysis. Results When DUP and DAP were compared as binary variables with long and short groups, 25.2% of individuals had differing category membership. DAP had a significant uncorrected association with both expressivity domain and motivation/pleasure domains at 24 months; however, relationship with DUP was not significant. DAP remained a significant predictor of 24-month expressivity domain after controlling for potential confounders. Conclusions Active psychosis after presentation is substantial, which is a limitation of DUP studies if active psychosis is considered as the key factor within DUP. DAP is a better predictor of negative symptoms than DUP at 2-year follow up, which suggests this concept requires further research.

Objectives The inflammatory marker C-reactive protein (CRP) is associated with depression. We examined the directional relations between CRP and symptoms of depression among older adults. Method The sample consisted of 3397 participants from the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults. CRP and depressive symptoms were measured at baseline and follow-up. A high CRP level was dichotomized as >3 mg/L. Elevated depressive symptomatology was defined as ≥4 using the 8-item Center for Epidemiologic Studies Depression Scale. Logistic regressions computed the association between high CRP levels at baseline with elevated depressive symptoms at follow-up, and vice versa. Results After adjusting for baseline depressive symptoms, baseline high CRP levels were associated with subsequent elevated symptoms of depression (OR = 1.49; 95% CI, 1.19–1.88). This relationship was no longer significant after simultaneous adjustments for metabolic and health variables. In the other direction, after adjusting for baseline CRP levels, baseline elevated depressive symptoms was not associated with subsequent high CRP levels (OR = 1.12; 95% CI, 0.88–1.42). Conclusion High CRP levels at baseline are related to elevated depressive symptomatology at follow-up due to clinical factors. No association was found in the opposite direction. Copyright © 2014 John Wiley & Sons, Ltd.

Background The aim of the present study was to investigate the stability and longitudinal association between depression and smoking status within a community sample with type 2 diabetes (T2D) while controlling for sociodemographic and disease-related variables. Methods Adults with T2D were recruited and agreed to be followed-up via random digit dialing for the Montreal Diabetes Health Study. At baseline, 1614 individuals were classified as never (n = 592), former (n = 690), light (≤10 cigarettes a day; n = 128) and moderate–heavy (11+ cigarettes a day; n = 204) smokers. Depression was assessed using the Patient Health Questionnaire-9 and individuals were classified as either “none” or having depression syndrome. Generalized estimating equations were used to test the association between depression syndrome and current smoking status while controlling for other demographic and health-related variables. Results Prevalence rates of smoking and depression showed mild to substantial agreement over time. Depression syndrome was significantly associated with moderate–heavy smoking in the fully adjusted model using cross-sectional (all four waves; odds ratio [OR] 1.46; 95% confidence interval [CI] 1.08–1.99; P < 0.05) and longitudinal (controlling for depression at baseline; OR 1.54; 95% CI 1.02–2.31; P < 0.05) data. Conclusions Smoking and depression prevalence rates appear to be stable over time in our community sample with T2D. Moderate–heavy smoking is strongly associated with elevated depression, both in cross-sectional and longitudinal models. Persistent moderate–heavy smokers may be at increased risk of both physical and mental health complications. This burden is even greater for those with T2D. 摘要 背景：本研究的目的是在一个社区2型糖尿病样本中调查经过社会人口统计学以及疾病相关变量校正之后的抑郁症与吸烟状态之间的稳定性以及纵向相关性。 方法：招募入组的2型糖尿病成年患者在知情同意之后通过蒙特利尔糖尿病健康研究的随机数字拨号系统进行随访。在基线时，将1614名患者分为从未吸烟者（n = 592）、曾经吸烟者（n = 690）、轻度吸烟者（每日≤10支香烟；n = 128）以及中-重度吸烟者（每日11+支香烟；n = 204）。使用患者健康调查表-9来评估抑郁症，将患者分为“无”或者“有”抑郁综合征。使用广义估计方程式，校正人口统计学以及健康相关变量后评估抑郁综合征与当前吸烟状态之间的关系。 结果：随着时间的推移，吸烟与抑郁症的患病率表现出了轻度至重度的一致性。在完全校正的模型中，无论是使用横断面数据（所有的4波；优势比[OR] ：1.46；95%可信区间[CI]：1.08-1.99；P

Objective Attention-deficit/hyperactivity disorder (ADHD) is an etiologically complex heterogeneous behavioral disorder. Several studies have reported that ADHD subjects are more likely to be overweight/obese and that this comorbidity may be due to shared genetic factors. The objective of this study is to explore the association between ADHD and FTO, a gene strongly associated with obesity in genome-wide studies. Design and Methods One tag SNP (single-nucleotide polymorphism, rs8050136, risk allele A) in the FTO gene was selected and its association with ADHD was tested. Family-based association tests (FBATs) were conducted with the categorical diagnosis of ADHD as well as behavioral and cognitive phenotypes related to ADHD. Furthermore, stratified FBAT analyses based on maternal smoking during pregnancy (MSDP) status were conducted. Results Statistically significant associations were observed between rs8050136 and several of the traits tested in the total sample. These associations were stronger when the analysis was restricted to children who were not exposed to MSDP. Conclusions These exploratory results suggest the involvement of the FTO SNP rs8050136 in modulating the risk for ADHD, particularly in those children who were not exposed to MSDP. If confirmed, they may explain, at least in part, the complex links between obesity and ADHD.

The role of allogeneic stem cell transplantation (HSCT) as compared to chemotherapy in acute myeloid leukaemia (AML) patients with abnormalities of chromosome 17p [abnl(17p)] has not yet been defined. Therefore, we analysed 3530 AML patients treated in three randomized, prospective, controlled clinical trials and compared post-remission therapies using a multivariate Cox regression analysis to determine whether allogeneic HSCT is superior than chemotherapy in overcoming the detrimental impact of patients with abnl(17p) AML. One hundred and forty-three patients (4%) were identified with abnl(17p) AML. All patients had received intensive induction chemotherapy. Forty-seven patients with a median age of 54 years (18-69 years) proceeded to allogeneic HSCT in first or second remission. The 3-year overall survival (OS) rate for the entire cohort of patients was 4% [95% confidence interval (CI), 1-7%]. OS and event-free survival at 3 years, calculated from the day of HSCT, was 11% (95% CI, 2-20%) and 6% (95% CI, 0-13%), respectively. Multivariate Cox regression analysis showed no benefit of allogeneic HSCT compared to chemotherapy (Hazard Ratio 0·97, 95% CI 0·56-1·67, P = 0·9). In conclusion, allogeneic HSCT does not improve survival in patients with abnl(17p) AML as compared to other adverse cytogenetic risk abnormalities.

Aim To describe the pattern of use of rehabilitation services in children and adolescents with cerebral palsy (CP), and to identify factors associated with use. Methods In this study, parents of 91 school-age children and 167 adolescents with CP completed a questionnaire regarding educational and rehabilitation resources received within the last 6 months. Rehabilitation services included occupational therapy (OT), physical therapy (PT), speech language pathology (SLP), psychology and special education. Demographic characteristics were documented and developmental and functional status was assessed. Relationships between service utilization and sociodemographic factors, functioning and school setting were determined. Results Over half of children (53.2%) and adolescents (57.5%) were in regular schools; however, 41% of these required special education resources. The remainder (42.5–46.8%) was in special schools. The majority of children (84.6%) were receiving at least one rehabilitation service although this decreased (68.1%) in adolescence. PT and OT were most common and services were provided predominantly in the school setting. Services were primarily weekly direct interventions at school age, with weekly interventions or consultations most common for adolescents. Younger age was associated with service receipt at school age only. Children with greater motor limitations, lower IQ and greater activity limitations were more likely to receive OT, PT, SLP or special education. Children in segregated schools were significantly more likely to receive rehabilitation services, when compared with children in regular schools. Conclusions The majority of children and youth received one or more services. Individuals with greater motor or cognitive challenges were more likely to receive a range of school-based services from rehabilitation specialists. When compared with children of school age, adolescents were less likely to receive services and when provided, services were more likely to be consultative. Services may need to be more optimally organized through childhood to enhance benefits to children with CP across activity limitation profiles. bs_bs_banner

Diabet. Med. 29, 1021–1028 (2012) Abstract Aims Self-rated health is a widely used measure of general health assessing risk factors and poor health outcomes in health surveys and clinical settings. The characteristics of self-rated health may be different in populations with specific chronic conditions, such as populations with diabetes. This study investigates the characteristics of self-rated health in a Canadian community sample of people with diabetes. Methods Self-rated health was obtained from 1837 adults with Type 2 diabetes participating in the Montreal Diabetes Health and Well-Being Study. Global disability and depression were assessed using the World Health Organization Disability Assessment Schedule II and the Patient Health Questionnaire, respectively. Logistic regressions studied the association between self-rated health and depression, disability, diabetes-related characteristics, socio-demographic factors, social support and lifestyle-related behaviours in both men and women. Results Participants’ answers were dichotomized into excellent/very good/ good (78%) and fair/poor (22%) self-rated health. Both depression (men: odds ratio 1.9, 95% CI 1.4–2.6; women: odds ratio 1.5, 95% CI 1.2–1.9) and disability (men: odds ratio 1.7, 95% CI 1.4–1.9; women: odds ratio 1.7, 95% CI 1.5–1.9) were associated with fair/poor self-rated health. The associations remained unchanged even after controlling for diabetes characteristics. After controlling for confounding variables, chronic conditions were associated with fair/poor self-rated health in both men and women. Obesity was associated with fair/poor self-rated health in women only, while lifestyle behaviours such as being physically active and alcohol consumption were associated with good/very good/excellent self-rated health in men. Conclusions In men and women, depression and disability are important factors that are associated with self-rated health in a large sample of individuals with Type 2 diabetes.

Diabet. Med. 29, 586–592 (2012) Abstract Aims Despite the detrimental effects of smoking on their health, a high number of adults with Type 2 diabetes continue to smoke. Identifying distinct types of smokers within this population could help tailor and target intervention programmes. This study examined whether smokers with Type 2 diabetes could be classified into different profiles based on smoking habits, socio-economic characteristics and lifestyle factors. Methods A sample of adults with self-reported diabetes was selected from random-digit dialling. Analyses included 383 participants with Type 2 diabetes who were current smokers. Information related to smoking, socio-economic status, health and lifestyle was collected by phone interview at baseline and 1 year later. Latent class analysis was used to identify subgroups of smokers. Results We uncovered three meaningful classes of smokers: class 1, long-time smokers with long-standing diabetes (n = 105); class 2, heavy smokers with deprived socio-economic status, poor health and unhealthy lifestyle characteristics (n = 105); class 3, working and active smokers who were more recently diagnosed with diabetes (n = 173). Members of class 2 were significantly more likely to be disabled and depressed at baseline and 1 year later compared with other classes. Conclusions Different profiles of smokers exist among adults with Type 2 diabetes, each suggesting different cessation treatment needs. Distinguishing between these types of smokers may enable clinicians to tailor their approach to smoking cessation.

BACKGROUND: Autologous stem cell transplantation (autoSCT) has improved the outcome of patients with mantle cell lymphoma (MCL) considerably. However, little is known about the patterns and outcome of MCL recurrence after autoSCT. METHODS: The authors conducted a retrospective study of 118 patients with MCL who underwent autoSCT from August 1992 to August 2008 at 3 different referral centers in Germany. RESULTS: Fifty-two relapses occurred for a cumulative incidence of 46% after 5 years. Only 3 patients relapsed after 5 years (at 90 months, 91 months, and 171 months) after undergoing autoSCT. A Cox regression analysis of the incidence of relapse identified not receiving rituximab before autoSCT and undergoing salvage autoSCT as predictive factors for relapse, whereas cytosine arabinoside intensification; a total body irradiation-based, high-dose regimen; patient age; and year of transplantation had no influence. The median overall survival (OS) after relapse was 23 months. Twenty patients (39%) underwent allogeneic stem cell transplantation (alloSCT) for relapse, and 11 of those patients remained in ongoing complete remission at the time of the current report. It is noteworthy that there were 4 long-term survivors who lived for >5 years after relapse even without undergoing alloSCT. A Cox regression analysis of OS after relapse revealed that the response duration after autoSCT was an adverse predictor of OS, whereas alloSCT was associated with a significantly longer OS after relapse. CONCLUSIONS: The current results indicated that autoSCT was capable of inducing long-term remission up to 16 years after treatment, but the outcome of patients with MCL who relapsed after autoSCT was poor, especially if their response duration after autoSCT was short. However, for a subset of patients with relapsed MCL, alloSCT may offer the possibility of durable survival, and individual patients can enjoy long-term survival after relapse even without undergoing alloSCT. Cancer 2011. © 2010 American Cancer Society.

Prior observational studies have investigated the association between obesity and depression but evidence remains weak and mixed. There has been a call for high-quality longitudinal studies to elucidate the etiologic relationship from obesity to depression. The main objective of this study was therefore to investigate whether obesity was a risk factor for depression in a nationally representative sample followed for 12 years. Seven waves of data collection (1994-1995 to 2006-2007) were obtained from the National Population Health Survey (NPHS). Our analyses included 10,545 adults without depression at baseline. Past-year major depression episode (MDE) was assessed from the Composite International Diagnostic Interview-Short Form for Major Depression (CIDI-SFMD). Obesity was estimated using baseline BMI from self-reported weight and height (obesity: BMI > or =30 kg/m(2)). Kaplan-Meier survival curves were generated and Cox proportional hazard regression modeling was used to estimate the risk of MDE by obesity status, controlling for sociodemographic and health and lifestyle variables. We found that obesity at baseline did not significantly predict subsequent MDE in women (adjusted hazard ratio (AHR): 1.03, 95% confidence interval (CI) 0.84-1.26) and negatively predicted MDE in men (HR: 0.71, CI 0.51-0.98), after adjusting for important confounders. In summary, our findings suggest that obesity is a significant (negative) predictor of depression in adult men but not in women. These results moderate prior evidence supporting a positive link from obesity to depression.

The aim of this study is to evaluate the effects of a trauma-focused psychotherapy upon war refugees from Bosnia. Seventy refugees who met the criteria for posttraumatic stress disorder (PTSD) and somatoform disorders were included. The first 35 refugees were offered psychotherapy and the following 35 refugees received usual care. Outcome variables were changes in self-reported PTSD symptoms, psychological symptoms, and health status. At 12-month follow-up, participants in the intervention group reported significantly lower scores on the PTSD scale and the measure of psychological symptoms than the comparison group participants. Our results suggest that psychotherapy reduces symptoms of PTSD and somatoform disorders among war refugees even in the presence of insecure residence status.

Objective: To assess whether an Early Case Identification Program (ECIP) for first-episode psychosis (FEP), which showed no significant short-term effects, has a delayed impact on duration of untreated psychosis (DUP). Method: Using a historical control design, FEP patients were assessed on clinical variables over three consecutive phases, 2 years prior, 2 years during and 3 years after implementation of the ECIP. Additional analyses were conducted on non-affective and schizophrenia spectrum psychoses cases only. Results: There was no overall significant difference in DUP across the three phases. For cases treated within the first year of illness a nonsignificant reduction in DUP to less than 2 months observed during the active phase was sustained post-ECIP. Conclusion: In some jurisdictions community-wide early case detection may fail to have an immediate or delayed effect on DUP, especially for cases who normally present for treatment with DUP >1 year.

Background: Patients with psychotic disorders are assumed to experience significant distress, especially during their first episode. It is unclear whether such distress is associated with the level of psychotic or other symptoms and/or to other characteristics such as level of self-esteem. Methods: One hundred and five patients who presented with first episode psychosis (FEP) (54% male; mean age 22.74 years; 79.4% schizophrenia; 20.6% affective psychosis) were administered the Symptom Checklist 90-Revised (SCL-90-R) at first presentation for treatment. Four indices derived from the SCL-90-R were used as measures of distress. Psychopathology was assessed with the Calgary Depression Scale, the Hamilton Anxiety Scale, the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms and self-esteem with the Self-esteem Rating Scale.Spearman's Correlation coefficients were calculated, followed by a regression analysis. Results: Measures of distress were highly correlated with depression (rho = 0.44–0.56), and anxiety (rho = 0.38–0.48), modestly with lack of judgement and insight (rho = −0.28 to −0.37) and not with positive or negative symptoms of psychosis. In a smaller sample (n = 68) distress measures were also highly correlated with self-esteem (rho = −0.55 to −0.73). Logistic regression confirmed that self-esteem explained 53% of the total variance explained (57%) by any combination of the independent variables. Conclusion: Distress experienced by individuals suffering from FEP is associated with levels of self-esteem, depression and anxiety and not with the level of psychotic or negative symptoms. Self-esteem may play a significant role in the magnitude of distress experienced by patients presenting with a FEP.

Mit grosen Teilchenbeschleunigern in Europa und USA versucht man, in energiereichen Kollisionen schwerer Atomkerne fur kurze Zeit auf kleinstem Raum ein Quark-Gluon-Plasma herzustellen. Dies ist ein neuer, vorher nicht beobachtbarer Materiezustand. In ihm haben sich die Bausteine der Atomkerne, die Protonen und Neutronen, in quasi-freie Quarks und Gluonen aufgelost. Nach dem modernen kosmologischen Modell befand sich unser Universum einige Mikrosekunden nach dem Urknall in diesem Zustand, als es noch sehr klein, heis und dicht war. Die Ergebnisse der bisherigen Beschleunigerexperimente am CERN und am Brookhaven National Laboratory weisen tatsachlich auf die Existenz dieses ungewohnlichen Materiezustandes hin, den die Quantenchromodynamik vorhersagt.

Vergleicht man die didaktische Konzeption des Seminars fur die gesamten Naturwissenschaften an der Universitat zu Bonn um 1850 mit den heutigen Forderungen zur Neustrukturierung der Gymnasiallehrerausbildung und den Vorschlagen zur Verbesserung des naturwissenschaftlichen Unterrichts an Schulen, so findet man auffallige Parallelen, auch wenn die Rahmenbedingungen damals und heute nicht vergleichbar sind. Diese Parallelen gilt es aufzuzeigen, denn dadurch wird erst deutlich, welche herausragende Rolle das Seminar zu Bonn bei der Umsetzung seiner didaktischen Konzeption fur die Lehrerausbildung in Naturwissenschaften spielte, eine Konzeption, die auch heute noch besticht und von deren ungebrochener Aktualitat uber die Zeiten hinweg man uberrascht wird. Hierbei sei naturlich zugestanden, dass zeitliche Umstande damals wie heute bei der Umsetzung der einen oder anderen Konzeption eine nicht zu unterschatzende Rolle spielen.

Survivin is overexpressed in several types of haematological malignancies making it an attractive target for therapeutic cytotoxic T-lymphocyte responses. Here, we identify two peptide epitopes derived from the murine survivin protein and demonstrate that Balb/c mice treated with syngeneic dendritic cells pulsed with the survivin epitopes were able to reject an otherwise lethal tumour inoculation of the A20 lymphoma. For the first time, these data provide evidence for the use of survivin peptide epitopes in T cell-based immunotherapeutic concepts against a B-cell lymphoma in vivo.

MIT DEM AUFBLUHEN der Realanstalten und der fortschreitenden Etablierung des Faches Chemie ruckten auch zunehmend Fragen der Gestaltung von Chemieunterricht in den Vordergrund. Dies soll anhand einiger Dokumente fruher Chemiedidaktiker an Schulen in Rheinpreusen und anderer deutscher Lander belegt werden. Dabei wird deutlich, dass viele Fragen heutiger Chemiedidaktik fruher schon gestellt und bearbeitet wurden. Gemeinhin gilt Rudolf Arendt als der Begrunder einer Didaktik der Chemie [1, 2], eine These, die vor einiger Zeit von Just [3] noch untermauert wurde. Rudolf Arendt bzw. Ferdinand Wilbrand wird das Verdienst zugeschrieben, den Chemieunterricht in Schulen aus den Fesseln der Stoffsystematik der Hochschulen befreit zu haben. Dies kann jedoch nur eine Teilwahrheit sein, denn es gibt zahlreiche Dokumente in den so genannten Schulprogrammen aus der Zeit vor Arendt, die eine andere Sprache sprechen. Es ist an der Zeit, sie aus ihrem Schattendasein hervorzuholen und einer fachkundigen Offentlichkeit zur Kenntnis zu bringen, damit sie eine entsprechende Wurdigung erfahren. Im Rahmen meiner Arbeit [4] bin ich auf eine Fulle von Hinweisen in dieser Richtung gestosen, die ich hier nicht alle ausbreiten kann. Zwei Dinge sollen jedoch stellvertretend besonders hervorgehoben werden. Es ist einmal das Wirken von drei Personlichkeiten im Rheinland, die sich als Lehrer in der didaktischen Aufbereitung des Lehrstoffs in Chemie besonders hervorgetan haben. Dabei tut es ihren Verdiensten keinen Abbruch, dass die Unterlagen in den Archiven nicht immer alle Lebensdaten bereithalten. Des weiteren mochte ich auf eine Reihe von Dokumenten anderer Personlichkeiten eingehen, die zeigen, dass die Wurzeln einer fruhen Didaktik der Chemie nicht auf Rheinpreusen beschrankt waren. Die Genese des Schulfaches Chemie ist eng mit der Entwicklung der Realanstalten verknupft. Da ist es naheliegend, bei der Suche nach den Wurzeln einer fruhen Didaktik der Chemie bei den Praktikern vor Ort zu beginnen, die sich bei der Konzeption ihres Unterrichts erstmals mit didaktischen Fragestellungen des neuen Faches auseinandersetzen mussten und noch nicht auf einen Fundus anderweitig gesicherter Erkenntnisse zuruckgreifen konnten.