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The experience of anxiety is central to the development of chronic pain. Music listening has been previously shown to exert analgesic effects. Here we tested if an active engagement in music making is more beneficial than music listening in terms of anxiety and pain levels during physical activity that is often avoided in patients with chronic pain. We applied a music feedback paradigm that combines music making and sports exercise, and which has been previously shown to enhance mood. We explored this method as an intervention to potentially reduce anxiety in a group of patients with chronic pain (N = 24, 20 female and 4 men; age range 34–64, M = 51.67, SD = 6.84) and with various anxiety levels. All participants performed two conditions: one condition, Jymmin, where exercise equipment was modified with music feedback so that it could be played like musical instruments by groups of three. Second, a conventional workout condition where groups of three performed exercise on the same devices but where they listened to the same type of music passively. Participants' levels of anxiety, mood, pain and self-efficacy were assessed with standardized psychological questionnaires before the experiment and after each condition. Results demonstrate that exercise with musical feedback reduced anxiety values in patients with chronic pain significantly as compared to conventional workout with passive music listening. There were no significant overall changes in pain, but patients with greater anxiety levels compared to those with moderate anxiety levels were observed to potentially benefit more from the music feedback intervention in terms of alleviation of pain. Furthermore, it was observed that patients during Jymmin more strongly perceived motivation through others. The observed diminishing effects of Jymmin on anxiety have a high clinical relevance, and in a longer term the therapeutic application could help to break the Anxiety Loop of Pain, reducing chronic pain. The intervention method, however, also has immediate benefits to chronic pain rehabilitation, increasing the motivation to work out, and facilitating social bonding.

Education is a human right, and among the indicators of human development, education is indisputably one of the most important ones for its impact both on individuals’ lives as well as on communities and countries at large. Despite its evident importance, it cannot be taken for granted that everyone has access to (high quality) education. Equality and equity in access to education is a priority policy issue not only in developing countries but also in developed countries. In this era of knowledge based economy, the extent to which countries are able to provide high quality education (however it may be defined) to all members of their society is a significant predictor of economic growth and socioeconomic development. Within this context, identifying the disadvantaged groups within the student population and finding ways to mitigate the negative effects of these disadvantages while at the same time targeting the students with special support needs are crucial policy objectives. The objective of this book is to focus on the case of a growing and diverse group, namely students with a migration background. We seek to examine the extent to which immigrant students are integrated to education systems in their new settlement countries, whether their relative achievement in schools require special attention in comparison with their native peers, and how the receiving countries with diverse immigrant populations deal with challenges related to immigrant student achievement in their education policy.

With the entrance of the video microscope over the recent few years into the microsurgery optical field, a third modality has emerged alongside the endoscope and operating microscope to accomplish some of the microsurgical procedures. One such approach that could potentially utilize any of the three is the transnasal transsphenoidal (TNTS) approach that provides access to the anterior brainstem, the anterior skull base, and of course the sellar region. Here, we provide a descriptive comparison of the three modalities on cadaveric specimens with joint ENT and neurosurgery teams performing the approach. Each provides unique advantages and disadvantages as part of the surgeon’s optical armamentarium. As more optical devices become available to surgeons, selection of the optimal device can present a challenge best compared by head-to-head comparison. The aim of this paper is to compare these modalities for the TNTS approach.

Kurzfassung: Die postpartale Depression (PPD) tritt mit einer Prävalenz von 520 % aller Entbindenden auf und hat ihren Häufigkeitsgipfel in der 2.6. postpartalen Woche. Zusätzlich zu den für eine Depression klassifizierten Symptomen wie Interessenverlust, Antriebslosigkeit und erhöhte Ermüdbarkeit treten im Rahmen der PPD kindbezogene Symptome wie Ambivalenz, Schuldgefühle gegenüber dem Kind, zwanghafte Impulse und Infantizidabsichten auf. Bisher existieren wenig umfassende Befunde zur Ätiologie und Pathogenese. Psychische Vorerkrankungen, verminderte soziale Unterstützung sowie Geburtskomplikationen und endokrinologische Faktoren werden mit der Entstehung einer PPD diskutiert. Inwiefern diese Faktoren zusammenhängen und sich gegenseitig beeinflussen, ist derzeit noch unklar. Auch die neuroanatomischen Grundlagen der postpartalen Depression sind bislang kaum erforscht. Aufgrund der möglichen verheerenden Auswirkungen der PPD ist eine frühzeitige Intervention notwendig. Zu diesem Zweck haben wir eine multimodale und interdisziplinäre Langzeitstudie entwickelt, um Frauen nach der Entbindung sowie Hebammen und Angehörige zu unterstützen und aufzuklären. Epidemiologische Daten und psychosoziale Faktoren werden neben Persönlichkeits- und Bindungsfaktoren sowie neuroanatomischen Aspekten untersucht. Ein umfassendes Beratungsangebot mittels Telefonhotline und therapeutischer Unterstützung wurde eingerichtet. Die ersten vorläufigen Ergebnisse unserer Studie zeigen, dass ein hoher Bedarf an Beratungsangeboten erforderlich ist, da ca. 50 Hotline-Anrufe in nur wenigen Monaten erfolgten. Die PPD-Prävalenz lag bei 8 % von 185 Frauen in einem Zeitraum von sechs Wochen nach der Entbindung. Bei 5 der 14 PPD-Patientinnen lag gleichzeitig eine verzögerte Bindung zum Kind vor. Mangelnde soziale Unterstützung sowie das Stillverhalten hingen nicht mit der PPD zusammen, vielmehr spielten psychische Vorerkrankungen in der Eigen- und Fremdanamnese eine Rolle. In unserem Kollektiv konnte bisher kein spezifischer "Key-Faktor" für die Entstehung einer PPD herausgestellt werden, vielmehr handelt es sich um eine multikausal bedingte Erkrankung. Es gibt erste Anhaltspunkte, dass die im klinischen Bild auffällige Persönlichkeitsstruktur mit hohem Selbstanspruch, eigene Bindungserfahrungen sowie das Körperbild bedeutsam für die Entstehung einer PPD sind. Dem wird im weiteren Verlauf der Studie verstärkt nachgegangen, ebenso wie den neuronalen Korrelaten.