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Harmanlanmış Öğrenme, geleneksel yüz yüze öğretim metotları ile eğitim amaçlı çevrim içi teknolojilerin entegre edilerek kullanıldığı bir yaklaşımdır. Bu yaklaşım, öğrencilere öğrenme süreçlerini kendilerinin yönetebilecekleri, öğrenci odaklı bir ortam sağlar ve bu yaklaşım dünya genelinde giderek daha popüler hale gelmektedir. Bu çalışmanın temel amacı öğretmen adaylarının harmanlanmış öğretime hazırbulunuşluk düzeylerini belirlemektir. Araştırmanın hedeflerine uygun olarak, betimsel tarama modeli tercih edilmiştir. Araştırmanın örneklem grubunu 2023-2024 eğitim-öğretim yılında Kastamonu Eğitim Fakültesinde 522 öğretmen adayı oluşturmuştur. Öğretmen adaylarına “Harmanlanmış Öğretime Hazırbulunuşluk Ölçeği” uygulanmıştır. Çalışmada elde edilen veriler SPSS 21 paket programında çözümlenmiştir. Verilerin analizinde t-testi, ANOVA, frekans ve yüzde kullanılmıştır. Araştırma sonunda öğretmen adaylarının harmanlanmış öğretime hazırbulunuşluk düzeyleri elde edilen bulgular incelendiğinde ölçekten alınan puanların ortalamasının (X=4,54) olduğu görülmüştür. En yüksek puanın 6 olduğu düşünüldüğünde öğretmen adaylarının harmanlanmış öğretime hazırbulunuşluk düzeylerinin %76’lık bir oranda olduğu görülmüştür. Araştırmada öğretmen adaylarının harmanlanmış öğretime hazırbulunuşluk düzeylerinin cinsiyete göre farklılık gösterdiği belirlenmiştir. Kız öğretmen adaylarının harmanlanmış öğretime hazırbulunuşluk düzeylerinin erkek öğretmen adaylarına göre daha yüksek olduğu görülmüştür.

Background: The study examines the psychometric properties of the ADHD section of the semi-structured diagnostic interview ILF-EXTERNAL, which was conducted online via video chat. Methods: As part of the INTEGRATE-ADHD research project, 202 children and adolescents (age M = 12.87 years, SD = 3.04, 28.2 % female) with an administrative diagnosis of ADHD registered with their health insurance company were clinically assessed for the presence of ADHD according to the German ADHD S3 guideline. Using the ILF-EXTERNAL, one parent and, from the age of eight, also the children themselves were interviewed. A proxy rating by a parent was made using the German FBB-ADHS rating scale. In a subsample (n = 65), an independent blind interviewer rated the videorecordings of the ILF-EXTERNAL parent interview to determine the interrater reliability of the ILF-EXTERNAL. Results: All ADHD symptom scales of the ILF-EXTERNAL showed good to excellent internal consistency (α = 0.89 to 0.93). Interrater reliability was high for both categorical and dimensional analyses (κ = 0.78 and κ = 0.81; ICC(1,1) = 0.97 and 0.98). High correlations of the ILF-EXTERNAL parent interview with the FBB-ADHS (r = 0.79 to r = 0.85) and with the ILF-EXTERNAL child interview (r = 0.60 to r = 0.71) demonstrated convergent validity. Conclusions: Sound psychometric properties of the ILF-EXTERNAL were also confirmed for its use in an online setting. High interrater reliabilities demonstrate the quality of the ADHD diagnostics carried out in the consortium project INTEGRATE-ADHD.

Background: In the project INTEGRATE-ADHD, administrative and parent-reported ADHD diagnosis data of children and adolescents were linked at person level for the first time in Germany. This contribution analyses discrepancies between the data sources, considering sociodemographic characteristics. Methods: Parents of 5,461 0- to 17-year-olds insured with the German statutory health insurance company DAK-Gesundheit in 2020, who had a confirmed administrative diagnosis of ADHD (ICD-10 F90.0-9) in at least one quarter (M1Q criterion), were surveyed online about their child’s ADHD diagnosis and other health and care-related topics. Using logistic regression, associations between the presence of a parental report of the child’s administrative ADHD diagnosis and sociodemographic predictors were analysed. Results: 71.6 % of parents reported their child’s administrative diagnosis of ADHD in the survey. The diagnosis was significantly less likely to be reported by parents of girls, younger children, children with a migration background and children from nuclear families with both biological parents. There were no differences with regard to parental education, urbanisation (urban/rural) or density of care. Bivariate findings were confirmed in the multivariable model. Conclusions: Approximately one third of parents do not report their child’s administrative diagnosis of ADHD. The likelihood of parental reporting varies according to sociodemographic factors. This should be considered when contextualising the data sources in the future.

Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with increased costs for the family, the health care system and the society. Previous cost-of-illness studies in Germany usually focused on prevalent ADHD. This study addressed the research gap on health care resource utilisation and costs of children and adolescents with incident ADHD diagnosis using nationwide claims data from the statutory health insurance DAK-Gesundheit. Methods: A matched-control design (propensity score matching, 1:3 ratio) was used to examine the health care costs of incident ADHD patients compared with a non-ADHD control group, considering an observation period of four quarters. Besides bivariate statistics, multivariate analyses of total costs were used to consider relevant covariates. Results: Total health care costs for children and adolescents with ADHD in the first year after diagnosis exceeded those of the control group by € 1,505.3. According to the multivariate analysis, the group with incident ADHD had significantly higher (2.86-fold) health care costs when compared with non-ADHD peers. Sensitivity analyses proved these findings. In addition, the analyses identified children’s age and comorbidity index to be significantly associated with increased costs. Conclusions: ADHD in children and adolescents is associated with a significant economic burden. The results emphasise the need for social awareness, prevention, appropriate treatment and research efforts.

Background: This article examines discrepancies in the frequency of diagnoses of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Germany using information on health care utilisation from both administrative and parent-reported survey data linked at person level. Methods: 5,461 parents of 0- to 17-year-olds insured with DAK-Gesundheit in 2020 and being registered with a confirmed administrative ADHD diagnosis (ICD-10 F90.0-9) in at least one quarter in 2020 (M1Q criterion) were surveyed online on their child’s ADHD diagnosis, utilisation of specialist care and therapeutic service providers. With regard to the presence of a parental report of the child’s documented ADHD diagnosis, administrative data and survey data were bi- and multivariately analysed. Results: The response rate was 21.5 %. ADHD diagnoses were given more frequently in the context of paediatric care, but in the multivariable model with the administrative data only the diagnosis made by mental health professionals (OR = 2.78), in the model with the survey data only utilisation of mental health professionals (OR = 2.99) positively predicted the parental diagnostic report. With regard to the utilisation of therapeutic service providers, only the utilisation of occupational therapy was associated with the parental report of the diagnosis in both data sources. Conclusions: Parental non-reporting of a child’s administrative ADHD diagnosis in survey studies can be in part be explained by utilisation characteristics.

Background: The consortium project INTEGRATE-ADHD compared administrative data on the presence of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents with the results of a parent survey and a comprehensive clinical assessment based on the S3 guideline of the Association of the Scientific Medical Societies in Germany (AWMF). Due to the COVID-19 pandemic, the clinical assessment was carried out online. Methods: The article describes how a guideline-based clinical assessment of ADHD can be implemented in an online setting. A specially developed diagnostic matrix is presented to illustrate the assessment procedures and the diagnostic decision-making process. The matrix is intended to help the diagnostician to gain an overview of the numerous individual findings that have been collected using different assessment perspectives and methods (e.g. diagnostic interviews, rating scales, performance tests) in order to make a well-founded and transparent diagnostic decision. Discussion: The consortium project INTEGRATE-ADHD has shown that an online assessment can be implemented in a guideline-compliant manner and allows a valid clinical decision. The diagnostic strategy is discussed with reference to international guidelines and recommendations for online diagnostics (e.g. aspects of feasibility, acceptability and safety of the assessment procedures). The challenges and opportunities of using online assessments in clinical practice are also described.

Background: The health-related quality of life (HRQoL) of individuals living with Attention-deficit/hyperactivity disorder (ADHD) is known to be impaired. Identifying factors that influence HRQoL can provide important information for the development of prevention and intervention programmes for affected children and adolescents. The aim of the present study was to investigate health care-related and psychosocial risk and protective factors for HRQoL in children and adolescents with an administrative ADHD diagnosis. Methods: In the consortium project INTEGRATE-ADHD, n = 4,809 parents of children and adolescents aged 7 to 17 years participated in an online survey between October 2021 and August 2022 and answered questions regarding HRQoL (KIDSCREEN-27), health care utilisation, and psychosocial risk and protective factors. Multiple linear regression analyses were conducted to assess the association between these factors and the five HRQoL dimensions of the KIDSCREEN-27. Results: Findings indicate that parental psychopathology and parental burden were risk factors for lower HRQoL in children and adolescents with ADHD. Further, a positive association was found between the five HRQoL dimensions and the psychosocial factors family climate and social support, indicating that these are protective factors. Conclusions: The results highlight the importance of prevention and intervention programmes for individuals with ADHD that consider parental mental health and aim to strengthen resources such as the availability of good family climate and social support.

BackgroundThe Lihir Islands of Papua New Guinea, located in an area with high burden of malaria and hosting a large mining operation, offer a unique opportunity to study transmission. There, we investigated human and vector factors influencing malaria transmission.MethodsIn 2019, a cross-sectional study was conducted on 2,914 individuals assessing malaria prevalence through rapid diagnostic tests (RDT), microscopy, and quantitative PCR (qPCR). A logistic regression analysis identified infection-associated factors. Anopheles species distribution, biting behaviours, and sporozoite carriage were assessed through human landing catches and larval surveys.ResultsOverall malaria prevalence (any species) was 3.6% by RDT, 4.5% by microscopy, and 15.0% by qPCR. P. vivax accounted for 37.1% of infections, P. falciparum for 34.6%, P. malariae for 3.0%, P. ovale 0.2%, and mixed infections for 24.5%. Prevalence (qPCR) varied across geographic areas, from 8.5% in the mine-impacted zone (MIZ) to 27.0% in the non-MIZ. Other factors independently associated with infection risk included cohabiting with an infected individual (aOR = 1.94, 95%CI: 1.56-2.42), and residing in traditional housing (aOR = 1.65, 95%CI: 1.21-2.25). Children had double the infection risk compared to adults, and the use of long-lasting insecticidal-treated nets did not decrease risk of infection. An. punctulatus was the major vector in one of the four geographical areas; while An. farauti was predominant in the rest of them, both with an early biting behaviour but with different biting intensities by geographical area. Entomological inoculation rates ranged from 26.9 (95%CI: 12.3-45.2) infective bites per person-year in the MIZ to 441.3 (95%CI: 315.7-572.1) in the non-MIZ.ConclusionsMalaria transmission and infection was lower in the MIZ compared to other areas. Measures focusing on at-risk groups, including vector-control and transmission interruption methods, could be taken into account by the mine and the healthcare authorities to reduce malaria burden outside the MIZ.

Aims: This report summarizes clinical findings, diagnosis, management, and long term outcomes of a recalcitrant Plectosphaerella and Acanthamoeba keratitis. Methods and materials: An otherwise healthy male patient presented with a corneal infiltrate with predominantly fungal characteristics, but atypical in terms of progression. The infiltrate remained undiagnosed even after several scrapings, and aqueous tap cultures. Since conventional therapy with antifungals and intrastromal voriconazole injections was ineffective, a therapeutic keratoplasty was done. Results: The excised corneal button was cultured; molecular identification of the Acanthamoeba and fungus isolates revealed the rare T5 genotype and the even rarer Plectosphaerella cucumerina. Judicious use of antifungals and anti-amoebic drops in the post-operative period, combined with gradual introduction of steroids resulted in favourable visual outcome. Conclusions: The T5 is the second most frequent environmental Acanthamoeba, but rarely isolated clinically. Plectosphaerella keratitis has been reported only 4 times in the literature. Neither of these have been previously reported from India.

A variety of Tacrine-modified Schiff base analogues were developed via solvent free (green) method and structurally elucidated using 1HNMR, FTIR and UV–Vis analysis. High product yield was obtained from the synthesised molecules, which were produced efficiently at room temperature without the need of a solvent. The developed molecules were subsequently assessed for their potential to inhibit acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). These molecules revealed effective inhibition of AChE and BChE enzymes with IC50 values varying from 0.1 ± 0.02 to 0.3 ± 0.03 μM and 0.065 ± 0.01 to 0.3 ± 0.03 μM respectively. Compared to the standard Tacrine which has IC50 values of 0.35 ± 0.02 μM for AChE and 0.1 ± 0.01 μM for BChE. Notably, compound 3f showed strong inhibition among others for both the enzymes. The structure–activity relationship of derivatives synthesized were verified and established through molecular docking studies. Theoretical ADME studies also predicted excellent drug-likeness for all the synthesized molecules. Antioxidant activities were also assessed because elevated oxidative stress levels are linked with cognitive loss in Alzheimer's disease (AD). These findings suggest that the lead compound is potentially an effective inhibitor for the therapeutic management of AD.

Abstract Background Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic. Methods Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change. Results We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support. Conclusions The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.

According to the principles of the bottom-up approach to peace and development, true and sustainable development and social harmony can only emerge by individuals taking constructive actions towards peaceful individual and communal governance – something which each individual and each community must realise within themselves and on their own terms. Well-functioning local-level institutions can support this process. In the Papua New Guinean context, however, too little attention has been given to the most fundamental local institutions – the local-level government and the village court – which for the vast majority of people constitute the first point of contact with any formal political and legal system. This paper firstly reviews the operation, institutional framework and potential cooperation of these two local institutions, with a particular emphasis on those institutional aspects by which bottom-up development can take place and be strengthened and enhanced, leading ideally to empowered communities and increasing peace and prosperity. Secondly, it shows that the potential of both the local-level government and the village court is currently greatly unrealised. Finally, the paper aims to inspire, promote and demonstrate ways in which this potential can be realised, using two case studies and a discussion. It is believed that knowledge, awareness and realisation of such potential will promote a greater sense of individual, communal and social governance, and commitment to the rule of law, emerging from the bottom up and fostering social harmony.

This study explores how brain activity in response to positive, negative, and neutral contexts affects confidence during a decision-making task. Focusing on emotional and cognitive processing, the investigation examined variations in power in the delta, theta, alpha, and beta frequency bands. Participants showed consistent power distribution patterns within frequency ranges. Correlational studies of participant ratings revealed confidence levels for distinct graphic stimuli in each scenario. A significant correlation between positive stimuli indicated participants' persistent confidence and adaptable decision-making processes In contrast, the absence of correlation between negative stimuli revealed different confidence levels across individuals, suggesting a more varied decision-making process. A substantial correlation between neutral stimuli showed participants' constant confidence and a trustworthy decision-making process. These findings contribute to our understanding of the interplay between brain activity, emotional processing, and decision-making, highlighting the impact of emotional context on participants' confidence levels.

Background: Health Behaviour in School-aged Children (HBSC) is one of the largest international studies on child and adolescent health and cooperates with the World Health Organization (WHO). In Germany, adolescents aged 11, 13 and 15 are surveyed every four years about their health, health behaviour and social conditions. This article describes the HBSC study and in particular the methodology of the current 2022 survey and prior surveys conducted between 2009/10 and 2017/18. Method: 174 schools with a total of 6,475 students participated in the 2022 survey. The survey was conducted using questionnaires and covered a wide range of topics (including mental health, physical activity, bullying experiences, social determinants of health and experiences related to COVID-19). The 2022 survey was complemented by a school principal survey (N = 160). In addition to the current sample, the samples of the three previous surveys with representative data for Germany are presented: 2009/10 (N = 5,005), 2013/14 (N = 5,961) and 2017/18 (N = 4,347).: Discussion The health of children and adolescents is of great public health importance. The HBSC study makes a substantial contribution by providing internationally comparable results, analysing trends, and providing stakeholders with comprehensive and representative health monitoring data.

Background: Physical activity is central to health, beginning in childhood and adolescence, and regular monitoring provides important information for strategic decisions on promoting physical activity in Germany. Methods: The current survey cycle of the Health Behaviour in School-aged Children (HBSC) study gives an insight into the prevalence of the indicators daily recommended physical activity, high and low physical activity, and sporting activity among students aged between 11 and 15 for 2022. In addition, the data is compared to the survey cycles of the 2009/10, 2013/14, and 2017/18 school years and analysed over time. Results: The results of the current survey cycle show that 10.8 % of girls, 20.9 % of boys, and 12.4 % of gender diverse adolescents fulfil the daily physical activity recommendation. There are also major gender-specific differences for the other indicators. The group of gender diverse adolescents needs to be analysed further. The changes over time between 2009/10 and 2022 are relatively small. While girls’ physical activity habits decreased slightly for the various indicators between 2009/10 and 2022, boys’ prevalence remained relatively stable over the same period. Conclusions: Overall, in part due to the effects of the various COVID-19 lockdowns, the need for effective and population-based measures to promote physical activity in childhood and adolescence remains high.