von Alexander Häge ; Barbara Alm ; Tobias Banaschewski ; Katja Becker ; Michael Colla ; Christine Freitag ; Julia Geissler ; Alexander von Gontard ; Erika Graf ; Barbara Haack-Dees ; Susann Hänig ; Klaus Hennighausen ; Sarah Hohmann ; Christian Jacob ; Charlotte Jaite ; Christine Jennen-Steinmetz ; Viola Kappel ; Swantje Matthies ; Alexandra Philipsen ; Luise Poustka ; Wolfgang Retz ; Michael Rösler ; Katja Schneider-Momm ; Esther Sobanski ; Timo D. Vloet ; Andreas Warnke ; Thomas Jans
Multimodal treatment of children with ADHD often includes parent-child training (PCT). However, due to the high heritability, parents of children with ADHD are frequently also affected by the disorder, which is likely to constitute a significant barrier to successful treatment of the child. This secondary analysis of our randomized controlled multicentre AIMAC trial (ADHD in mothers and children) investigates whether children's outcomes following parent-child training in combination with maternal ADHD treatment depend on maternal symptom improvement. In a first step focusing on treatment of maternal ADHD, 144 mothers of mother-child dyads were randomized to multimodal ADHD treatment (group psychotherapy plus methylphenidate) or clinical management (mainly supportive counselling). After 12 weeks (T2), a 12-week PCT program (T2-T3) for all mother-child dyads was added to treat children's ADHD. Maternal symptomatology (CAARS-O:L; SCL-90-R) and children's externalizing symptoms (ADHD-ODD Scale, SDQ) were repeatedly assessed (T1 = baseline, T2, T3). Effects of changes in maternal symptomatology (T1-T2) on the change in children's symptom scores (T1-T3) were analysed using a general linear model, controlling for baseline scores, study centre, and maternal treatment group. 125 mother-child dyads were analysed. Mothers showed significant improvements in ADHD symptoms and overall psychopathology [CAARS-O:L ADHD index: mean - 3.54, SE 0.74 p < 0.0001; SCL-90-R Global Severity (GS): mean - 11.03, SE 3.90, p = 0.0056]. Although children's externalizing symptoms improved significantly (ADHD-ODD Scale: mean - 4.46, SE 0.58, p < 0.0001), maternal improvement had no effect on children's outcomes after Bonferroni-Holm correction for multiple testing. The findings do not support our hypothesis that children's outcomes following PCT for ADHD depend on maternal symptom improvements.Trial register CCT-ISRCTN73911400.
European child & adolescent psychiatry Darmstadt : Steinkopff, 1992 27(2018), 8, Seite 1011-1021 Online-Ressource
von David Capper ; David T. W. Jones ; Daniel Schrimpf ; Dominik Sturm ; Christian Kölsche ; Felix Sahm ; David Reuss ; Annekathrin Kratz ; Annika K. Wefers ; Kristin Huang ; Kristian Wilfried Pajtler ; Leonille Schweizer ; Damian Stichel ; Florian Selt ; Hendrik Witt ; Till Milde ; Olaf Witt ; Wolfram Scheurlen ; Christoph Geisenberger ; Stefanie Brehmer ; Marcel Seiz-Rosenhagen ; Daniel Hänggi ; Andreas Kulozik ; Axel Benner ; Martin Bendszus ; Jürgen Debus ; Michael Platten ; Andreas Unterberg ; Wolfgang Wick ; Marcel Kool ; Christel Herold-Mende ; Andreas von Deimling ; Stefan Pfister ; Hermann L. Müller
Accurate pathological diagnosis is crucial for optimal management of patients with cancer. For the approximately 100 known tumour types of the central nervous system, standardization of the diagnostic process has been shown to be particularly challenging—with substantial inter-observer variability in the histopathological diagnosis of many tumour types. Here we present a comprehensive approach for the DNA methylation-based classification of central nervous system tumours across all entities and age groups, and demonstrate its application in a routine diagnostic setting. We show that the availability of this method may have a substantial impact on diagnostic precision compared to standard methods, resulting in a change of diagnosis in up to 12% of prospective cases. For broader accessibility, we have designed a free online classifier tool, the use of which does not require any additional onsite data processing. Our results provide a blueprint for the generation of machine-learning-based tumour classifiers across other cancer entities, with the potential to fundamentally transform tumour pathology.
Nature London [u.a.] : Nature Publ. Group, 1869 555(2018), 7697, Seite 469-474 Online-Ressource
von Cristina Cezar ; Sven Becker ; Attilio Di Spiezio Sardo ; Anja Herrmann ; Angelika Larbig ; Vasilis Tanos ; Luz Angela Torres-de la Roche ; Hugo Christian Verhoeven ; Markus Wallwiener ; Rudy Leon de Wilde
PurposeUterine myomas are the main cause of benign uterine diseases in premenopausal women. Objective of the present paper is to investigate the current best treatment modalities of myomas, depending on age of the patient and her desire to preserve fertility, as well as on clinical presentation of this pathology, such as size, number, and location of fibroids and, furthermore, on surgical experience of the gynecologist.MethodsThe design of our work is a systematic literature review of existing studies, reviews, and meta-analysis conducted in PubMed and Cochrane Library to identify relevant literature. Commonly, the myomectomy is to be recommended in women desiring to preserve fertility when myomas are associated with symptoms such as excessive bleeding, pelvic discomfort, or palpable abdominally fibroids.SummaryThe decision of surgical approach for myomectomy should be individualized, depending on size and location, as well as on surgeon’s experience. The different modalities of myomectomy, laparoscopic, hysteroscopic, robotic-assisted, or laparotomic are in detail presented in the paper, according to Society of Obstetricians and Gynecologists of Canada (SOGC) clinical practice guidelines and taking into consideration possible concerns of myomectomy such as uterine rupture, development of adhesions, and myomas’ recurrence.
Archives of gynecology and obstetrics Berlin : Springer, 1870 296(2017), 4, Seite 709-720 Online-Ressource
von Michael Alber ; Vera M. Kalscheuer ; Elysa Marco ; Elliot Sherr ; Gaetan Lesca ; Marianne Till ; Gyri Gradek ; Antje Wiesener ; Christoph Korenke ; Sandra Mercier ; Felicitas Becker ; Toshiyuki Yamamoto ; Stephen W. Scherer ; Christian R. Marshall ; Susan Walker ; Usha R. Dutta ; Ashwin B. Dalal ; Vanessa Suckow ; Payman Jamali ; Kimia Kahrizi ; Hossein Najmabadi ; Berge A. Minassian
Langjährige Reihen der Wetteraufzeichnung und Schadensstatistiken zeigen, dass Anzahl und Inten-sität von extremen Wetterereignissen in Deutschland in den letzten Jahrzehnten zugenommen hat. Bedingt durch den Klimawandel wird eine Verschärfung dieser Trends vor allem für Hitzewellen, Hochwasser und Starkniederschläge erwartet. Viele der hierdurch zu erwartenden Schäden lassen sich jedoch durch Eigenvorsorge reduzieren beziehungsweise vermeiden. Der zielgruppengerechten Kommunikation von Risiken und Vorsorgemöglichkeiten kommt bei der Vorsorge eine entscheidende Rolle und die psychologische Naturgefahrenforschung zeigt, dass Kata-strophenszenarien in der Kommunikation eher eine Abwehrhaltung erzeugen, die konkrete Darstel-lung von Vorsorgemaßnahmen hingegen motivierend wirkt.adelphi hat im Rahmen dieses Vorhabens das vorhandene Wissen über handlungsmotivierende Kommunikation zur Eigenvorsorge mittels Literaturrecherchen, Medienresonanzanalysen und reprä-sentativen Umfragen erweitert. Es wurden adäquate Kommunikationsprodukte für zwei Zielgruppen entwickelt, erprobt und zur Stärkung der Eigenvorsorge im Rahmen von Kampagnen eingesetzt.
According to weather and damage statistics recorded over the past decades, the overall number and intensity of extreme weather events in Germany is on the rise. It is anticipated that this trend will continue to intensify as a result of climate change, leading in particular to increased heat waves, floods, and heavy precipitation. However, much of the damage associated with such calamities can be reduced or even avoided through the use of appropriate provisions.When it comes to prevention, the particular communication strategies concerning risks and preven-tive measures are shown to play an important role with target groups. Psychological research in the area of natural hazards indicates that the communication of disaster scenarios tend to induce a de-fensive posture, whereas concrete examples of preventive measures tend to be motivating.In this project, adelphi used literature reviews, media analysis, and representative surveys to build upon existing knowledge of action-motivating communication strategies concerning individual pro-visions. Appropriate communication approaches have been subsequently developed, tested, and used to strengthen the particular provisions for the campaigns of two target groups.
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