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"Kompetenz und Diagnostik"
(2014)
OBJECTIVE To compare the emotional and behavioral problems of children of patients suffering from cancer or a mental disorder and their association with parental quality of life. METHODS A total of 223 children from 136 families and their 160 parents were investigated from multiple perspectives in a cross-sectional study. The consistency of different adjustment reports between family members was examined. Through mixed models, the differences between parental HRQoL and the children's symptomatology were studied with regard to the type of parental illness. The prediction of children's adjustment through parental HRQoL was further examined. Additionally, gender and age of the children were considered. RESULTS Half of the children exhibited psychosocial problems. Gender and age differences were independent of the type of parental disease. In families with parental cancer, the reports of children's adjustment were more consistent between family members than in families where a parental mental disorder was present. We found differences in HRQoL between families with mentally ill parents and those with parental cancer patients. Specifically, the healthy partners of mentally ill parents showed worse HRQoL compared with healthy partners of cancer patients. Healthy parents' reduced HRQoL was associated with worse adjustment in their children, regardless of the type of parental illness, but this result was not found for ill parents. CONCLUSION Family members confronted with parental cancer or mental disorders are more burdened compared with those from the normal population, independently of the type of disease. Our results indicate that the type of a parental disease has no direct effect on children's adjustment. However, there are disease-specific effects on parental HRQoL, which are associated with children's adjustment.
An international consensus for assessing internet gaming disorder using the new DSM-5 approach
(2014)
Automatic Classification of Left Ventricular Wall Segments in Small Animal Ultrasound Imaging.
(2014)
Brunos Welt im Urlaub
(2014)
BACKGROUND Children of patients with cancer are at increased risk for developing emotional and behavioral problems. This study explored the prevalence and predictors of emotional and behavioral problems in Children of cancer patients in a multisite research project. METHODS A cross-sectional sample of N = 235 families was recruited simultaneously in 5 university medical centers. The participants, including parents (N = 402) and children (N = 324; ages 11-21 years) completed standardized questionnaires. Emotional and behavioral problems in children were measured by the Strengths and Difficulties Questionnaire (SDQ). On the basis of previous research and using a mixed-model approach, child-, parent-, family- and cancer-related variables were examined in addition to socioeconomic status as potential predictors. Descriptive statistics and a multiple random coefficient model were used in the analyses. RESULTS Compared to norms, Children of cancer patients show increased mean levels of emotional and behavioral symptoms. The best predictor of emotional and behavioral problems from the perspectives of the child, the healthy parent, and the ill parent was general family dysfunction. Although family dysfunction was identified as the main predictor, the analysis revealed that the main part of variance was related to the individual child's level. CONCLUSIONS The results indicate that screening for child mental health problems and family dysfunction in oncological and psychosocial treatment units can identify the families most in need of psychosocial support. Psychological services need to be both family-oriented and child-centered and focus on family dysfunction to prevent mental health problems in children.
Objectives
Complex midfoot injuries could lead to severe functional impairment of mobility and quality of daily living. Aim of this study was to compare the clinical and functional outcomes of Chopart, Lisfranc fractures and multiple metatarsal shaft fractures.
Design
Retrospective case series.
Setting
Level one trauma center.
Intervention
Open or closed reduction and internal fixation with screws, K-wires, plates, external fixation or combination of different technics.
Main outcome measurements
The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Maryland Foot Score were used to assess pain and functional outcome. 3D gait analysis, pedobarographic analysis and radiologic examinations were performed. The activity level was measured by a step counting accelerometer. All results were compared to an age-matched healthy control group.
Results
24 patients with a median age of 44 years (16–72) were included: 12 patients with multiple metatarsal shaft fractures, 6 patients with Chopart and 6 patients with Lisfranc fractures. The median follow-up was 2.6 years. The pedobarographic analysis reports reduced contact time of the total foot (p = 0.08), the forefoot (p = 0.008) and the hallux (p = 0.015) for the injured foot. A median score of 64 for the SF-36, 64 for the AOFAS Midfoot Score and 73 for the Maryland Foot Score indicated a poor restoration of foot function. Multiple metatarsal shaft fractures presented a significantly lower walking speed (p = 0.03) and cadence (p = 0.04).
Conclusion
The worst results were reported for multiple metatarsal shaft fractures on outcome scores, pedobarography, gait analysis and activity. Metatarsal serial fractures should not be underestimated as well as Chopart and Lisfranc fractures.
Competence Development Assessment in Teacher Education: Design and Evaluation of Portfolio Exams
(2014)
In einer Pilotstudie wurden 31 Erzieherinnen (Alter: MW = 41,4; sd = 11,2 Jahre; Berufserfahrung: MW = 18,6; sd = 11,5 Jahre) von 17 Kindern mit Typ-1-Diabetes (Alter: MW = 4,5; sd = 1,3 Jahre; Betreuungszeit pro Woche: MW = 29,8; sd = 8,9 Stunden) zur Betreuungssituation in der Kindertageseinrichtung befragt. Über 70 % der Erzieherinnen verfügten nach eigenen Angaben über ein grundlegendes Krankheits- und Therapiewissen und fühlten sich bei der Betreuung des Kindes „sicher“ (35,5 %) bzw. „eher sicher“ (51,6 %). An einer Diabetesschulung hatten 64,5 % der Befragten teilgenommen; 22,6 % äußerten Schulungsbedarf. Die Erzieherinnen führten beim betreuten Kind ein- bis mehrmals täglich Blutzuckerkontrollen durch (MW = 3,8; sd = 1,6) und verabreichten Insulin (MW = 2,7; sd = 1,6) oder unterstützten das Kind bei diesen Therapieaufgaben. 41,9 % der Erzieherinnen vertraten die Ansicht, dass ihre zeitlichen Ressourcen nicht ausreichen, um ein Kind mit Typ-1-Diabetes angemessen zu betreuen. Während der Betreuungszeit in der Kindertageseinrichtung hatten 64,5 % der Erzieherinnen mehrfach eine Hypo- oder Hyperglykämie des Kindes erlebt. Im Hinblick auf das Verhalten in kritischen Situationen, die Berechnung von BE/KE sowie die Berechnung der Insulindosis äußerte jeweils mehr als ein Viertel der Befragten weiteren Informationsbedarf und Angst vor Behandlungsfehlern. Die Zusammenarbeit mit den Eltern wurde positiv wahrgenommen.
The clinical treatment of children and adolescents with gender dysphoria is still a controversial issue. The aim of this study was to get an overview of the knowledge and experience of international experts and to highlight shared views as well as differences in theoretical convictions and treatment approaches. Half-structured, guide-line based interviews were carried out with international experts in the field. The interviews were analyzed using qualitative content analysis (Mayring, 2010).
The aim was to evaluate the effects of additional exercises during inpatient stays on bone mass in pediatric bone tumor patients. 21 patients were non-randomly allocated either to the exercise group (n=10) or the control group (n=11). DXA of the lumbar spine, the non-affected femur and both calcanei was performed after completion of neoadjuvant chemotherapy (baseline), as well as 6 and 12 months after baseline. Bone mineral content (BMC), bone mineral density (BMD) and height-corrected lumbar spine Z-scores were determined. Group changes after 6 and 12 months were compared by covariance analyses. Additionally, daily physical activities (PA) were assessed by means of accelerometry. After adjusting for initial age, height and weight, mean reductions in lumbar spine and femoral BMC were lower in the exercise group (not significant). Effect sizes during the observational period for lumbar spine and femur BMC were generally small (partial η²=0.03). The exercise group demonstrated substantially higher PA levels in terms of gait cycles per day, per hour and moderate PA (activities above 40 gait cycles per minute). Additional exercises for bone tumor patients are feasible during hospitalization. Though the intervention did not influence BMC, it appeared beneficial regarding PA promotion with respect to volume and intensity.