bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethische Aspekte von Patienteninformationen – Können Informationen auch schaden?
Authors: Middel Claus-Dieter
Published: January 2011

Einleitung

Mit dem Abschied vom medizinischen Paternalismus und mit dem Konzept der Patientenautonomie geht in ethischer und rechtlicher Hinsicht die Anerkennung eines individuellen Abwehrrechts einher: Ein Patient darf nicht gegen seinen Willen behandelt werden. Dieses Abwehrrecht ist grundrechtlich als Teil des Persönlichkeitsrechts und des Rechts auf körperliche Unversehrtheit verbrieft. Voraussetzung für eine informierte Entscheidung des Patienten über Nutzen, Risiken und Nebenwirkungen einer medizinischen Maßnahme ist der Zugang zu allen in diesem Zusammenhang notwendigen Informationen. Dies gewährleisten u.a. Patienteninformationen, die umfassend und verständlich Auskunft geben über den eine bestimmte Krankheit betreffenden Stand der Erkenntnisse der medizinischen Wissenschaft, verschiedene Untersuchungs- und Behandlungsmöglichkeiten sowie ggf. über Institutionen des Gesundheitswesens.
Dimensionen der Patientenorientierung in der Integrierten Versorgung am Beispiel Gesundes Kinzigtal
Authors: Siegel Achim , Zimmermann Linda , Stößel Ulrich
Published: January 2011

Einleitung

Bei der Ausgestaltung von Gesundheitsversorgungssystemen rückt eine Frage zunehmend in den Vordergrund: Wie können angesichts der Eigeninteressen und der Eigendynamik von Versorgungsinstitutionen die Anliegen und Interessen der Patienten gestärkt werden? So sah der Sachverständigenrat 2003 viele Organisationsformen im Gesundheitswesen zwar als leistungserbringer- oder versichererorientiert, aber als wenig patientenorientiert. Als Hoffnungsträger einer stärkeren Patientenorientierung wurde u.a. die Integrierte Versorgung gesehen. Dieser Beitrag erläutert am Beispiel der 2005 gegründeten Integrierten Versorgung Gesundes Kinzigtal die Entwicklung und das Potenzial einer populationsbezogenen Integrierten Versorgung in Sachen Patientenorientierung.
Landscape and Power in Early China
Authors: Feng Li
Published: January 2011

The ascendancy of the Western Zhou in Bronze Age China, 1045–771 BC, was a critical period in the development of Chinese civilisation and culture. This book addresses the complex relationship between geography and political power in the context of the crisis and fall of the Western Zhou state. Drawing on the latest archaeological discoveries, the book shows how inscribed bronze vessels can be used to reveal changes in the political space of the period and explores literary and geographical evidence to produce a coherent understanding of the Bronze Age past. By taking an interdisciplinary approach which embraces archaeology, history and geography, the book thoroughly reinterprets late Western Zhou history and probes the causes of its gradual decline and eventual fall. Supported throughout by maps created from the GIS datasets and by numerous on-site photographs, Landscape and Power in Early China gives significant insights into this important Bronze Age society.
Mitochondrial and nuclear markers highlight the biodiversity of Kalotermes flavicollis (Fabricius, 1793) (Insecta, Isoptera, Kalotermitidae) in the Mediterranean area
Authors: Velonà A. , Luchetti A. , Ghesini S. , Marini M. , Mantovani B.
Published: January 2011

The biodiversity of the European termite Kalotermes flavicollis is here studied through the analysis of mitochondrial (303 bp of control region and 912 bp of COI/tRNALeu/COII) and nuclear (five microsatellite and 20 Inter-SINE loci) markers on 18 colonies collected in Southern France, Corsica, Sardinia, peninsular Italy, the Balkans and Greece. Different statistical analyses (Bayesian phylogenetic analysis, parsimony network, F-statistics, PCA) were performed. Mitochondrial sequences produced an unresolved polytomy including samples from peninsular Italy, Balkans and Greece, and three main clades: southern France, Corsica-Sardinia and Portoscuso (SW Sardinia). Nuclear markers confirm these data, further highlighting a more significant divergence at the regional scale. The results obtained for the peri-Tyrrhenian area agree with major paleogeographic and paleoclimatic events that shaped the biodiversity of the local fauna. K. flavicollis biodiversity and its phylogeographic pattern are also evaluated in the light of the data available for the other native European termite taxon (genus Reticulitermes), in order to produce a more complete scenario of the Mediterranean. In the area comprised between southern France and Italy, the degree of diversity is similar; however, in the eastern area, while K. flavicollis is differentiated only at the population level, the genus Reticulitermes comprises at least six entities of specific and/or subspecific level. This discrepancy may be explained by taking into account the different evolutionary histories of the two taxa.
Variation in actual relationship as a consequence of Mendelian sampling and linkage
Authors: HILL W.G. , WEIR B.S.
Published: January 2011

Although the expected relationship or proportion of genome shared by pairs of relatives can be obtained from their pedigrees, the actual quantities deviate as a consequence of Mendelian sampling and depend on the number of chromosomes and map length. Formulae have been published previously for the variance of actual relationship for a number of specific types of relatives but no general formula for non-inbred individuals is available. We provide here a unified framework that enables the variances for distant relatives to be easily computed, showing, for example, how the variance of sharing for great grandparent–great grandchild, great uncle–great nephew, half uncle–nephew and first cousins differ, even though they have the same expected relationship. Results are extended in order to include differences in map length between sexes, no recombination in males and sex linkage. We derive the magnitude of skew in the proportion shared, showing the skew becomes increasingly large the more distant the relationship. The results obtained for variation in actual relationship apply directly to the variation in actual inbreeding as both are functions of genomic coancestry, and we show how to partition the variation in actual inbreeding between and within families. Although the variance of actual relationship falls as individuals become more distant, its coefficient of variation rises, and so, exacerbated by the skewness, it becomes increasingly difficult to distinguish different pedigree relationships from the actual fraction of the genome shared.
Direct numerical simulation of the turbulent boundary layer over a cube-roughened wall
Authors: LEE JAE HWA , SUNG HYUNG JIN , KROGSTAD PER-ÅGE
Published: January 2011

Direct numerical simulation (DNS) of a spatially developing turbulent boundary layer (TBL) over a wall roughened with regularly arrayed cubes was performed to investigate the effects of three-dimensional (3-D) surface elements on the properties of the TBL. The cubes were staggered in the downstream direction and periodically arranged in the streamwise and spanwise directions with pitches of px/k = 8 and pz/k = 2, where px and pz are the streamwise and spanwise spacings of the cubes and k is the roughness height. The Reynolds number based on the momentum thickness was varied in the range Reθ = 300−1300, and the roughness height was k = 1.5θin, where θin is the momentum thickness at the inlet, which corresponds to k/δ = 0.052–0.174 from the inlet to the outlet; δ is the boundary layer thickness. The characteristics of the TBL over the 3-D cube-roughened wall were compared with the results from a DNS of the TBL over a two-dimensional (2-D) rod-roughened wall. The introduction of cube roughness affected the turbulent Reynolds stresses not only in the roughness sublayer but also in the outer layer. The present instantaneous flow field and linear stochastic estimations of the conditional averaging showed that the streaky structures in the near-wall region and the low-momentum regions and hairpin packets in the outer layer are dominant features in the TBLs over the 2-D and 3-D rough walls and that these features are significantly affected by the surface roughness throughout the entire boundary layer. In the outer layer, however, it was shown that the large-scale structures over the 2-D and 3-D roughened walls have similar characteristics, which indicates that the dimensional difference between the surfaces with 2-D and 3-D roughness has a negligible effect on the turbulence statistics and coherent structures of the TBLs.
Low-Mach-number asymptotics for two-phase flows of granular materials
Authors: VARSAKELIS C. , PAPALEXANDRIS M. V.
Published: January 2011

In this paper, we generalize the concept of low-Mach-number approximation to multi-phase flows and apply it to the two-phase flow model of Papalexandris (J. Fluid Mech., vol. 517, 2004, p. 103) for granular materials. In our approach, the governing system of equations is first non-dimensionalized with values that correspond to a reference thermodynamic state of the phase with the smaller speed of sound. By doing so, the Mach number based on this reference state emerges as a perturbation parameter of the equations in hand. Subsequently, we expand each variable in power series of this parameter and apply singular perturbation techniques to derive the low-Mach-number equations. As expected, the resulting equations are considerably simpler than the unperturbed compressible equations. Our methodology is quite general and can be directly applied for the systematic reduction of continuum models for granular materials and for many different types of multi-phase flows. The structure of the low-Mach-number equations for two special cases of particular interest, namely, constant-density flows and the equilibrium limit is also discussed and analysed. The paper concludes with some proposals for experimental validation of the equations.
In vitroinduction of lymph node cell proliferation by mouse bone marrow dendritic cells following stimulation with differentEchinococcus multilocularisantigens
Authors: Margos M.C. , Grandgirard D. , Leib S. , Gottstein Bruno
Published: January 2011

The immune response of mice experimentally infected withEchinococcus multilocularismetacestodes becomes impaired so as to allow parasite survival and proliferation. Our study tackled the question on how different classes ofE. multilocularisantigens (crude vesicular fluid (VF); purified proteinic rec-14-3-3; purified carbohydrate Em2(G11)) are involved in the maturation process of bone-marrow-derived dendritic cells (BMDCs) and subsequent exposure to lymph node (LN) cells. In our experiments, we used BMDCs cultivated from either naïve (control) or alveolar echinococcosis (AE)-infected C57BL/6 mice. We then tested surface markers (CD80, CD86, MHC class II) and cytokine expression levels (interleukin (IL)-10, IL-12p40 and tumour necrosis factor (TNF)-α) of non-stimulated BMDCs versus BMDCs stimulated with different Em-antigens or lipopolysaccharide (LPS). While LPS and rec-14-3-3-antigen were able to induce CD80, CD86 and (to a lower extent) MHC class II surface expression, Em2(G11) and, strikingly, also VF-antigen failed to do so. Similarly, LPS and rec-14-3-3 yielded elevated IL-12, TNF-α and IL-10 expression levels, while Em2(G11) and VF-antigen didn't. When naïve BMDCs were loaded with VF-antigen, they induced a strong non-specific proliferation of uncommitted LN cells. For both, BMDCs or LN cells, isolated from AE-infected mice, proliferation was abrogated. The most striking difference, revealed by comparing naïve with AE-BMDCs, was the complete inability of LPS-stimulated AE-BMDCs to activate lymphocytes from any LN cell group. Overall, the presenting activity of BMDCs from AE-infected mice seemed to trigger unresponsiveness in T cells, especially in the case of VF-antigen stimulation, thus contributing to the suppression of clonal expansion during the chronic phase of AE infection.
Outcome and relative cost of transoral removal of submandibular calculi
Authors: Shashinder S , Morton R P , Ahmad Z
Published: January 2011

Objective:

To examine the outcomes and treatment cost of transoral removal of submandibular calculi, and to compare the outcomes and costs of other reported techniques.

Method:

Retrospective review of 60 consecutive patients undergoing transoral removal of submandibular calculi. All clinical, operative, post-operative and follow-up data were collated and outcomes analysed.

Results:

A total of 61 submandibular glands were treated by the transoral approach. Patients with multiple stones (p = 0.034) and stones in the proximal submandibular duct (p = 0.0028) were at greater risk of requiring submandibular gland excision, compared with patients with single stones and stones in the distal duct, respectively. There was a significant difference between the gland preservation rate during the first versus the second half of the study (p = 0.028). Larger calculi were significantly more likely to be seen in the proximal duct (p < 0.001). The mean operating time (28 minutes) and length of hospital stay for transoral removal of submandibular calculi was much less than those for other treatment techniques.
An unusual myofibroblastic proliferation of the pinna
Authors: Rowan C , Farboud A , Mitchard J , Trinidade A
Published: January 2011

Introduction:

Myofibrosis of the ear is rare. Myofibromas are mesenchymal tumours which usually present in infancy but have been reported sporadically in adults.

Objective:

To present a rare case of trauma as a cause of pinnal myofibrosis.

Design and method:

Case report. A 29-year-old soldier suffered repeated trauma from helmet wear and sports, and presented to our clinic with an exquisitely painful lump in the anti-helix of the pinna.

Results:

The lump was excised uneventfully. Pathology revealed a reactive myofibroblastic proliferation which, given the history of trauma, raised the possibility of a florid cellular repair process. The main differential diagnosis was myofibroma. Immunohistochemistry was used to exclude other possible causes.

Conclusion:

No similar case has previously been reported. The aetiology of myofibroma is unclear, but repeated trauma may be a trigger. Histological and immunohistochemical analysis are recommended when the diagnosis is ambivalent.
The influence of physical activity on appetite control: an experimental system to understand the relationship between exercise-induced energy expenditure and energy intake
Authors: Caudwell Phillipa , Gibbons Catherine , Hopkins Mark , Naslund Erik , King Neil , Finlayson Graham , Blundell John
Published: January 2011

Investigations of the impact of physical activity on appetite control have the potential to throw light on the understanding of energy balance and therefore, upon body weight regulation and the development of obesity. Given the complexity of the landscape influencing weight regulation, research strategies should reflect this complexity. We have developed a research approach based on the concept of the psychobiological system (multi-level measurement and analysis) and an experimental platform that respects the operations of an adaptive regulating biological system. It is important that both sides of the energy balance equation (activity and diet) receive similar detailed levels of analysis. The experimental platform uses realistic and fully supervised levels of physical activity, medium-term (not acute) interventions, measurement of body composition, energy metabolism (indirect calorimetry), satiety physiology (gut peptides), homeostatic and hedonic processes of appetite control, non-exercise activity, obese adult participants and both genders. This research approach has shown that the impact of physical activity on appetite control is characterised by large individual differences. Changes in body composition, waist circumference and health benefits are more meaningful than changes in weight. Further, we are realising that the acute effects do not predict what will happen in the longer term. The psychobiological systems approach offers a strategy for simultaneously investigating biological and behavioural processes relevant to understanding obese people and how obesity can be managed. This experimental platform provides opportunities for industry to examine the impact of foods under scientifically controlled conditions relevant to the real world.
Normal subgroups of diffeomorphism and homeomorphism groups of ℝn and other open manifolds
Authors: SCHWEITZER, S. J. PAUL A.
Published: January 2011

We determine all the normal subgroups of the group of Cr diffeomorphisms of ℝn, 1≤r≤∞, except when r=n+1 or n=4, and also of the group of homeomorphisms of ℝn ( r=0). We also study the group A0 of diffeomorphisms of an open manifold M that are isotopic to the identity. If M is the interior of a compact manifold with non-empty boundary, then the quotient of A0 by the normal subgroup of diffeomorphisms that coincide with the identity near to a given end e of M is simple.
Badly approximable numbers and Littlewood-type problems
Authors: BUGEAUD YANN , MOSHCHEVITIN NIKOLAY
Published: January 2011

We establish that the set of pairs (α, β) of real numbers such that

where ‖ · ‖ denotes the distance to the nearest integer, has full Hausdorff dimension in R2. Our proof rests on a method introduced by Peres and Schlag, that we further apply to various Littlewood-type problems.
On statistical attractors and the convergence of time averages
Authors: KARABACAK ÖZKAN , ASHWIN PETER
Published: January 2011

There are various notions of attractor in the literature, including measure (Milnor) attractors and statistical (Ilyashenko) attractors. In this paper we relate the notion of statistical attractor to that of the essential ω-limit set and prove some elementary results about these. In addition, we consider the convergence of time averages along trajectories. Ergodicity implies the convergence of time averages along almost all trajectories for all continuous observables. For non-ergodic systems, time averages may not exist even for almost all trajectories. However, averages of some observables may converge; we characterize conditions on observables that ensure convergence of time averages even in non-ergodic systems.
Valuations of Somos 4 sequences and canonical local heights on elliptic curves
Authors: UCHIDA YUKIHIRO
Published: January 2011

Somos 4 sequences are sequences of numbers defined by a bilinear recurrence relation of order 4 and include elliptic divisibility sequences as a special case. In this paper, we describe valuations of Somos 4 sequences in terms of canonical local heights on the associated elliptic curves. We consider both Archimedean and non-Archimedean valuations. As applications, we study the asymptotic behaviour of valuations of Somos 4 sequences and obtain another proof of the integrality of certain Somos 4 sequences.
The diphtheria vaccine debacle of 1940 that ushered in comprehensive childhood immunization in the United Kingdom
Authors: MORTIMER P. P.
Published: January 2011

In January 1940 British Ministry of Health circular 1307 proposed the introduction of mass childhood diphtheria immunization. This was a policy reversal after a decade during which opportunities for diphtheria prophylaxis were ignored, or resisted on grounds of cost. Diphtheria toxoid was to be the first of many centrally funded childhood immunizations in the UK and it set a pattern that has now held good for over 70 years. The circumstances in 1940 were particularly fortuitous, and diphtheria toxoid has since given successive generations of children a lifetime's protection from the disease; but difficulties have been experienced in introducing and evaluating some of the more recent immunizations, and in maintaining and justifying them in the face of parental scepticism and academic or pressure-group opposition, however ill-founded this may have been. The task of decision-making with regard to new candidate vaccines demands a careful balancing against the costs of the expected benefits during the recipient's lifespan.
Dynamics in children and adolescents who experience varicella zoster virus infections after haematopoietic stem cell transplantation: a case-control study
Authors: AYTAÇ S. , YALÇIN S. S. , KÜÇÜKBAYRAK Ö. , ÇETİN M. , UÇKAN D.
Published: January 2011

We evaluated the incidence of varicella-zoster virus (VZV) infections, including herpes zoster (HZ), and investigated the associated risk factors for HZ and compared lymphocyte subsets of these patients at 1, 3 and 6 months following haematopoietic stem cell transplantation (HSCT) in a case-control study in children and adolescents. The incidence of HZ infection at the first year after HSCT was 17/125 (13·6%). The cumulative incidence of HZ infection was 22/125 (17·6%). Sixteen (73%) cases with HZ and 11 (32%) cases in the control group had a diagnosis of malignant disorder. No significant difference was noted between the HZ group and the control group in absolute lymphocyte number and subsets (except WBC) at the pre-transplant evaluation. Pre-transplant WBC count was statistically lower in the HZ group (P<0·05). The CD4/CD8 ratios were lower in the HZ group during the first 6 months after HSCT, and the decrease was statistically significant at 6 months compared to the control group. In conclusion, patients undergoing HSCT for a malignant disorder had a significantly higher risk of VZV infection than those with non-malignant disorders and pretransplant donor characteristics were not helpful in predicting risk of post-transplant VZV infection.
Timing of seed dispersal and dormancy, rather than persistent soil seed-banks, control seedling recruitment of woody plants in Neotropical savannas
Authors: Salazar Ana , Goldstein Guillermo , Franco Augusto C. , Miralles-Wilhelm Fernando
Published: January 2011

A large fraction of tree species forming persistent soil seed-banks and with dormant seeds are expected to be found in strongly seasonal ecosystems such as Neotropical savannas, where seedling recruitment could be highly variable. In the savannas of Central Brazil, we studied seed characteristics (type of dormancy, longevity and moisture content) of 14 representative woody species differing in seed dispersal season. We also studied the dynamics of soil seed-banks and similarity patterns in woody species composition among seed rain, soil seed-bank, seedling bank and standing vegetation along shallow topographic gradients that differ in canopy cover. Woody species composition of the soil seed-bank largely differed from the standing vegetation, the seed rain and the seedling bank species composition, suggesting low recruitment of woody species from the soil seed-bank. Seeds of the 14 woody species remained viable for less than 16 months in laboratory dry-storage conditions. Of those, most seeds dispersed in the dry season were dormant and exhibited low moisture content, while most seeds dispersed in the wet season were non-dormant and exhibited high moisture content. Longevity of these seeds dispersed in the dry and the wet seasons did not differ significantly. This study shows that both timing of seed dispersal and dormancy appear to control timing of seed germination and seedling recruitment of most Neotropical savanna woody species, which did not form persistent soil seed-banks. This study contributes to the understanding of tree/grass coexistence and tree density variations along topographic gradients in tropical savannas.
Organic weed control in white lupin (Lupinus albus L.)
Authors: Folgart A. , Price A. J. , van Santen E. , Wehtje G. R.
Published: January 2011

Legumes such as white lupin (Lupinus albus L.) provide a valuable nitrogen source in organic agriculture. With organic farming hectarage increasing and white lupin interest increasing in the southeastern USA due to newly released winter hardy cultivars, non-chemical weed control practices in lupin are needed. A two-year experiment was established at two locations in Alabama. Five weed control practices were evaluated: one pre-emergence (PRE)-applied herbicide (S-metolachlor), two mechanical (hand hoed) and two cultural (living mulch utilizing two black oat cultivars) weed control treatments. Fourteen weed species were encountered. S-metolachlor provided above 80% control of most weed species present in this experiment. The cultivation treatments and black oat companion crops also provided good weed control of many of the weeds encountered. Crop injury of all treatments was low on a 0 to 10 scale with 0 representing no injury: <2.0, <1.3 and <1.2 by S-metolachlor, the cultivation treatments and the black oat companion crops, respectively. Grain yield of cultivars ABL 1082, AU Alpha and AU Homer were 1540, 1130, 850 kg ha−1, respectively, when treated with the conventional treatment, S-metolachlor. Grain yield in the organic treatments was equivalent. The cultivation treatments and black oat companions were successful alternative weed control practices in white lupin production.
Impact of reduced tillage on soil organic carbon and nutrient budgets under organic farming
Authors: Gadermaier Florian , Berner Alfred , Fließbach Andreas , Friedel Jürgen Kurt , Mäder Paul
Published: January 2011

No-tillage (NT) and reduced tillage (RT) systems are well-known management tools for reducing soil erosion and improving soil fertility. NT and RT may improve the environmental and economic performance of organic farming, but they are still not common practice among organic farmers. This paper presents the effects of tillage [RT versus conventional tillage (CT)], fertilization (slurry versus manure compost) and biodynamic preparations (with versus without) on soil fertility indicators such as soil organic carbon (Corg), microbial biomass and microbial activity, soil nutrients and nutrient budgets in an organic farming system during the first six-year crop rotation period of a long-term experiment on a clayey soil in a temperate climate. RT caused stratification of soil organic carbon (Corg), microbial properties and soil nutrients in the soil profile. Under RT, Corgin the 0–10 cm soil layer increased from 2.19 to 2.61% (w/w) from 2002 to 2008, whereas it remained constant under CT. In both tillage treatments, Corgremained constant in the 10–20 cm soil depth. Microbial biomass C increased by 37% under RT in the 0–10 cm soil depth and microbial activity [dehydrogenase activity (DHA)] was enhanced by 57%. Soil microbial biomass C and DHA in the 10–20 cm soil depth were also higher under RT (+10 and +17%, respectively). Soluble soil P and K were 72 and 40%, respectively, higher in 0–10 cm soil depth under RT when compared with CT. Fertilization showed no effects on the measured soil properties. Biodynamic preparations increased solely the Cmic-to-Nmic(soil microbial biomass C to soil microbial biomass N) ratio by 7% in the 0–10 cm soil depth. Nutrient budgets for P were balanced in all treatments, but N and K exports were higher under RT compared to CT. We conclude that RT is a suitable method for increasing indicators of soil fertility in organic farming systems. The combined effects of RT and an organic farming system with a diverse, ley-based crop rotation and organic fertilization merit further promotion and it may be considered for supporting actions by the agricultural policy schemes.
Tabakrauchen und Alkoholkonsum bei Patienten mit Kehlkopfteilresektion fünf Jahre nach der Diagnose Kehlkopfkrebs
Authors: Danker Helge , Herrmann Esther , Keszte Judith , Meyer Alexandra , Wollbrück Dorit , Dietz Andreas , Meister Eberhard F. , Wulke Cornelia , Singer Susanne
Published: January 2011

Zusammenfassung. Tabak- und Alkoholkonsum sind Hauptrisikofaktoren für die Entstehung von Kehlkopfkrebs. Post-operativ fortgesetztes Risikoverhalten kann negative gesundheitliche Auswirkungen haben. Ziel der Arbeit waren die Beschreibung des Alkohol- und Tabakkonsums von Patienten nach krebsbedingter Kehlkopfteilresektion und die Identifizierung von Bedingungen, die die Wahrscheinlichkeit gesundheitlichen Risikoverhaltens beeinflussen. Es wurden 151 Kehlkopfkrebspatienten nach Larynxteilresektion befragt. Untersucht wurden postoperativer Alkohol- und Tabakkonsum sowie soziodemografische, medizinische und psychosoziale Parameter: Depressivität, Ängstlichkeit, erlebte soziale Unterstützung, Progredienzangst, Geschlecht, soziale Schicht, Alter und Tumorstadium. Binär logistische Regressionsanalysen wurden zur Schätzung gesundheitlichen Risikoverhaltens eingesetzt. Zum Zeitpunkt der Befragung waren 22% Raucher. Personen, die kaum soziale Unterstützung erhielten, hatten im Vergleich zu Personen mit guter Unterstützung eine höhere Chance (OR = 8,67) weiterhin zu rauchen. Der Alkoholkonsum war bei 28% der Männer gesundheitsschädigend hoch. Nur zwei der Befragten brachten ihren Alkoholkonsum mit der Krankheitsentstehung in Zusammenhang und 44% mit dem Rauchen. Anders als beim Rauchen bedingte hohe soziale Unterstützung postoperativen Alkoholkonsum (OR = 11,20). Gesundheitliches Risikoverhalten wird nicht selten nach einer Erkrankung an Kehlkopfkrebs aufrechterhalten. Während den Betroffenen die Schädlichkeit des Rauchens weitgehend bekannt erscheint, ist sie hinsichtlich des Alkohols deutlich weniger bewusst. Dies könnte sich auch in dem Umstand widerspiegeln, dass gute soziale Unterstützungssysteme einerseits den Alkoholkonsum stimulieren und andererseits den Tabakkonsum verhindern helfen. Ein Bedarf an professioneller Aufklärung und Unterstützung scheint in Anbetracht der Studienergebnisse angezeigt.
Copingeffektivität und Progredienzangst bei Krebskranken
Authors: Dinkel Andreas , Henrich Gerhard , Herschbach Peter
Published: January 2011

Zusammenfassung. Progredienzangst (PA), die Angst vor dem Fortschreiten der Erkrankung, ist ein häufiges Phänomen bei Krebskranken. In einer Therapiestudie konnten wir zeigen, dass dysfunktionale PA mittels gruppentherapeutischer Interventionen reduziert werden kann. In der vorliegenden Analyse untersuchten wir, ob diese Interventionen einen Einfluss auf die Copingeffektivität haben, d.h. auf die Häufigkeit, mit der hilfreiche Handlungen im Umgang mit PA eingesetzt werden. An der Längsschnittstudie nahmen N = 265 Krebspatienten in stationärer Rehabilitationsbehandlung teil. Das Durchschnittsalter der Patienten betrug M = 53.7 Jahre (SD = 10.2). Brustkrebs war die häufigste Krebsdiagnose (58.9%). Die Patienten wurden randomisiert einer kognitiv-verhaltenstherapeutischen (KVT) oder einer supportiv-erfahrungsorientierten (SET) Gruppentherapie zugewiesen. Die Kontrollgruppe erhielt die Standardbehandlung und wurde ein Jahr später in die Studie aufgenommen. Die Patienten machten vor und nach der Behandlung sowie 3 und 12 Monate später Angaben zu Copingeffektivität und zu PA. Copingeffektivität und PA korrelierten r = –.34, p < .001. Die ANOVA erbrachte eine Interaktion, welche einen unterschiedlichen Verlauf der Copingeffektivität in Abhängigkeit der Gruppe anzeigte (p = .051). Die KVT und die SET Intervention führten zu einer kurzfristigen Steigerung der Copingeffektivität (prä/post). Zum Katamnesezeitpunkt (12 Monate) lag kein Unterschied in der Copingeffektivität zwischen den drei Gruppen vor. Die Effektstärke der KVT-Intervention betrug ES = 0.19. Die Ergebnisse dieser explorativen Analyse zeigen, dass eine kurze gruppentherapeutische Behandlung gegenüber der Standardbehandlung die Copingeffektivität positiv beeinflusste. Der fehlende Langzeiterfolg und die niedrige Effektstärke regen dazu an, die Interventionen weiter zu optimieren.
Gesundheitsverhalten von Hautkrebspatienten während der Melanomnachsorge
Authors: Körner Annett , Augustin Matthias , Zschocke Ina
Published: January 2011

Zusammenfassung. Das maligne Melanom ist die häufigste Krebserkrankung im mittleren Erwachsenenalter. Es zeichnet sich durch besonders hohe Heilungschancen in frühen Krankheitsstadien und Therapieresistenz metastasierter Melanome aus. Zudem ist das Melanom einer der wenigen soliden Tumore, die sich – beobachtbar für den Fachmann aber auch für den medizinischen Laien – an der Hautoberfläche entwickeln. Die Überlebenswahrscheinlichkeit wird primär durch das Melanomstadium zum Zeitpunkt der Diagnose bestimmt. Die frühzeitige Behandlung von Krankheitsprogression ist von entscheidender Bedeutung für die Dauer und Qualität der verbleibenden Lebenszeit. Dementsprechend fokussieren Interventionen zur Senkung melanombedingter Morbidität und Mortalität auf die frühestmögliche Entdeckung der Melanome und der Krankheitsprogression. Regelmäßige Hautselbstuntersuchungen als sekundäre und tertiäre Präventionsmaßnahme stellen ein hocheffektives Komplement zu ärztlicher Vor- und Nachsorge dar, da die Mehrzahl der Melanome sowie die Krankheitsprogression von Patienten, deren Familie und Freunden selbst entdeckt werden. Eine wichtige Fragestellung stellt daher das auf die Melanomerkrankung bezogene Selbstuntersuchungsverhalten und Möglichkeiten seiner Optimierung dar. Psychoonkologische Forschung hat bisher darauf fokussiert, Handlungsergebniserwartung und Selbstwirksamkeitserwartung durch dermatologische Patientenschulung zu erhöhen. Die vorliegende Studie untersucht psychosoziales Belastungserleben und Krankheitsbewältigung in ihrer Bedeutung für das Selbstuntersuchungsverhalten in einer Stichprobe von 164 Patienten in der Melanomnachsorge. Mehr als 70% der Patienten gaben an, nicht von ihrem Arzt zur Selbstuntersuchung angeleitet worden zu sein. Angeleitete Patienten maßen der Selbstuntersuchung höhere Bedeutung bei und praktizierten diese häufiger, obwohl sie sich dadurch unangenehm an die Krebserkrankung erinnert fühlten. Nichtinstruierte Patienten zeigen ein weniger funktionales Verhaltensmuster: Die Selbstuntersuchungshäufigkeit wurde u.a. durch erlebte Selbstunsicherheit, mangelnde ärztliche Unterstützung und berufliche/finanzielle Probleme bestimmt, während das objektive Rückfallrisiko keine Rolle spielte. Auf Basis dieser sowie weiterer psychoonkologischer Befunde und gesundheitspsychologischer Paradigmen wird ein integratives Modell für die dringend notwendige Forschung und evidenzbasierte Praxis der individuellen Gesundheitsfürsorge bei Personen mit erhöhtem Melanomrisiko vorgeschlagen.
Repeat Callers and the Samaritan Telephone Crisis Line—A Canadian Experience
Authors: Hall Barry , Schlosar Hilde
Published: January 2011

Telephone crisis lines are increasingly providing a much needed service in the community to the lonely, the depressed, and the suicidal. The Samaritan volunteer crisis line discussed here is open to any person at any time, day or night. The instant availability of such an anonymous service attracts callers who use the line inappropriately; these people are often referred to as repeat callers. The Samaritans discovered that repeat callers were creating serious problems for both staff and volunteers. The difficult task was to develop a policy to restrict the repeat callers, but at the same time ensuring that the mandate of the crisis line was offered to them. This article examines the characteristics of repeat callers, and makes suggestions about the management of the chronic caller.
Preventing Suicide in Women and Men
Authors: Lester David
Published: January 2011

A review of gender differences in the response to suicide prevention strategies suggests that they may be more effective in helping suicidal women than suicidal men. More attention needs to be given to the problem of directing these strategies to suicidal men.
A Repetition-Prediction Study on European Parasuicide Populations
Authors: Bille-Brahe U. , Kerkhof A. , De Leo D. , Schmidtke A. , Crepet P. , Lönnqvist J. , Michel K. , Salander-Renberg E. , Stiles T.C. , Wasserman D. , Egebo H.
Published: January 2011

One of the aims of the inter-European study on parasuicide, which was initiated by WHO/Euro in the mid-1980s, was to try and identify social and personal characteristics predictive of future suicidal behavior. A follow-up interview study (the Repetition-Prediction Study) was designed, and so far 1145 interviews have been carried out at nine research centers, representing seven European countries. The study and the instrument used (the European Parasuicide Study Interview Schedules, EPSIS I and II) are described here. Some basic characteristics of the material from the various centers are presented and compared, and the representativeness of the samples are discussed. There were differences between the centers in several respects. Results from analyses based on pooled data have to be treated with some caution because of the possible lack of representativeness.
The WHO-EURO Multicentre Study: Risk of Parasuicide and the Comparability of the Areas Under Study
Authors: Bille-Brahe U. , Andersen K. , Wasserman D. , Schmidtke A. , Bjerke T. , Crepet P. , De Leo D. , Haring C. , Hawton K. , Kerkhof A. , Lönnqvist J. , Michel K. , Phillippe A. , Querejeta I. , Salander-Renberg E. , Temesváry B.
Published: January 2011

The 15 areas under study in the WHO/Euro Multicentre Study on Parasuicide vary considerably with regard to socio-economic factors, culture, life-styles, etc. In this paper, the authors discuss whether the traditional high risk factors for suicidal behavior (such as unemployment, abuse, divorce, etc.) take on different weights depending on local societal and cultural settings. Results from analyzing covariations between various background factors characteristic of the different areas under study and the frequency of attempted suicide showed weak or insignificant correlations, indicating that high-risk factors can only be identified from international pooled data with great care.
The Typology of Personality Disorders — Diagnostic Problems and Their Relevance for Suicidal Behavior
Authors: Bronisch Thomas
Published: January 2011

Personality disorders (PD) play an important role in clinical psychiatry. The typologies of personality disorders (PDs) found in different classification systems, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), are quite congruent. There are many methodological problems with reliability and validity of the diagnosis of PD. However, having a typology seems to be very helpful. Recent psychological autopsy studies reported that about one third of suicide victims met the criteria for a PD. Antisocial PD, borderline PD, narcissistic PD, and depressive PD in particular were often clinically associated with suicidal behavior.
Religiosity and Suicide: Findings from a Nation-wide Psychological Autopsy Study
Authors: Sorri H , Henriksson M , Lönnqvist J
Published: January 2011

Using data from a nationwide psychological autopsy study of all suicides in Finland occurring over a 1-year period, the authors investigated religiosity and its types among suicide victims. Overt active religiosity was identified in 245 (18%) of the victims. A history of psychiatric inpatient treatment and psychotic and depressive disorders diagnosed in psychiatric care were more common among the religious victims than among the nonreligious. The burden of major mental disorders seems to have been heavier among religious than nonreligious victims. The type of religiosity of victims was qualitatively characterized into four categories: (1) help-seeking from a religious congregation, (2) conflict with a religious congregation, (3) private religiosity, and (4) abandoned religiosity. Further research needs to address the psychological contents and psychiatric implications of different types of religiosity among suicidal individuals.
Alcohol Problems Among Suicide Attempters in the Nordic Countries
Authors: Søgaard Nielsen Anette , Bille-Brahe Unni , Hjelmeland Heidi , Jensen Børge , Ostamo Aini , Salander-Renberg Ellinor , Wasserman Danuta
Published: January 2011

The purpose of this study was to see whether and how the number of suicide attempters with alcohol problems and their drinking habits differ between the Nordic areas under study. Problem-drinkers were defined as persons who themselves felt that they had an alcohol problem. The analyses were based on data collected at five Nordic research centers participating in the WHO/Euro Multicentre Study on Parasuicide, namely: Helsinki (Finland); Umeå and Stockholm (Sweden); Sør-Trøndelag (Norway); and Odense (Denmark). The results showed that the frequency of problem-drinking among suicide attempters differed markedly between the areas under study; the Finnish male and the Danish female suicide attempters included the highest proportions of self-identified problem-drinkers. The pattern of drinking among the suicide attempters also differed between the areas. The analyses indicate that the point when alcohol becomes a problem to somebody, especially to a degree that it increases the risk of suicidal behavior, not only depends on how much and how often the person drinks alcohol; the prevailing drinking pattern, the attitudes towards drinking alcohol, and the level of social control are also important factors to take into consideration when relations between alcohol and suicidal behavior are under study.
Measuring Consumers’ Information Acquisition and Decision Behavior With the Computer-Based Information-Display-Matrix
Authors: Aschemann-Witzel Jessica , Hamm Ulrich
Published: January 2011

The former judgment that the process-tracing method information-display-matrix (IDM) lacks external validity should be questioned in the light of technical advances and changing consumer behavior. The new research environment offers possibilities for a close-to-realistic refinement and further development of the method: starting points are choice of location, increased relevance of choice, individual adjustment of task structure, simplified navigation, and realistic layout. Used in multi-measurement-approaches, the IDM can provide detailed background information about consumer information behavior prior to decisions reached in interviews or choice experiments. The contribution introduces to the method and its’ development, use, and (dis-)advantages. Results of a survey illustrate the options for analysis and indicate that consumer behavior in the IDM, compared to face-to-face-interviews, is less biased by social desirability.
Understanding pool‐riffle dynamics through continuous morphological simulations
Authors: de Almeida Gustavo Adolfo Mazza , Rodríguez José F.
Published: January 2011

Pool‐riffle dynamics is governed by complex time and spatial interactions between water and sediment flows. In the last few decades, significant advances have been made in characterizing and modeling the hydrodynamics of pool‐riffle sequences, and this information has been extensively used as the basis of conceptual models to describe or infer pool‐riffle morphodynamics. A lot less attention, however, has been paid to the coupled dynamics of flow and sediment, which is essential to fully understand these complex geomorphic systems. This paper uses an unsteady 1‐D flow‐morphology and bed‐sorting model to analyze pool‐riffle dynamics. The model is first applied to a pool‐riffle sequence on a 1.1 km reach of the lower Bear Creek, Arkansas, United States. After showing the model's ability to describe the general reach hydrodynamics and morphological evolution over 1 year, the detailed sediment and flow information is used to investigate pool‐riffle dynamics in terms of self‐maintenance mechanisms. Two effects that have been only marginally explored in the past, i.e., bed sediment sorting and downstream riffle control, are explained and quantified with the help of the model's outputs. The results show that self‐maintenance occurs more frequently than previously thought as a result of grain sorting and that erosion or deposition of contiguous riffles also constitutes a self‐maintenance mechanism. These findings provide the support for a physically based, integral description of pool‐riffle morphodynamics and highlight the importance of flow and sediment variability on pool‐riffle self‐maintenance. The morphodynamic analysis bridges the gap between observations and current theories based mainly on hydrodynamic information.
Comparative genomics of two newly isolated Dehalococcoides strains and an enrichment using a genus microarray
Authors: Lee Patrick K H , Cheng Dan , Hu Ping , West Kimberlee A , Dick Gregory J , Brodie Eoin L , Andersen Gary L , Zinder Stephen H , He Jianzhong , Alvarez-Cohen Lisa
Published: January 2011

Comparative genomics of Dehalococcoides strains and an enrichment were performed using a microarray targeting genes from all available sequenced genomes of the Dehalococcoides genus. The microarray was designed with 4305 probe sets to target 98.6% of the open-reading frames from strains 195, CBDB1, BAV1 and VS. The microarrays were validated and applied to query the genomes of two recently isolated Dehalococcoides strains, ANAS1 and ANAS2, and their enrichment source (ANAS) to understand the genome–physiology relationships. Strains ANAS1 and ANAS2 can both couple the reduction of trichloroethene, cis-dichloroethene (DCE) and 1,1-DCE, but not tetrachloroethene and trans-DCE with growth, whereas only strain ANAS2 couples vinyl chloride reduction to growth. Comparative genomic analysis showed that the genomes of both strains are similar to each other and to strain 195, except for genes that are within the previously defined integrated elements or high-plasticity regions. Combined results of the two isolates closely matched the results obtained using genomic DNA of the ANAS enrichment. The genome similarities, together with the distinct chlorinated ethene usage of strains ANAS1, ANAS2 and 195 demonstrate that closely phylogenetically related strains can be physiologically different. This incongruence between physiology and core genome phylogeny seems to be related to the presence of distinct reductive dehalogenase-encoding genes with assigned chlorinated ethene functions (pceA, tceA in strain 195; tceA in strain ANAS1; vcrA in strain ANAS2). Overall, the microarrays are a valuable high-throughput tool for comparative genomics of unsequenced Dehalococcoides-containing samples to provide insights into their gene content and dechlorination functions.
Co-occurrence patterns for abundant marine archaeal and bacterial lineages in the deep chlorophyll maximum of coastal California
Authors: Beman J Michael , Steele Joshua A , Fuhrman Jed A
Published: January 2011

Microorganisms remineralize and respire half of marine primary production, yet the niches occupied by specific microbial groups, and how these different groups may interact, are poorly understood. In this study, we identify co-occurrence patterns for marine Archaea and specific bacterial groups in the chlorophyll maximum of the Southern California Bight. Quantitative PCR time series of marine group 1 (MG1) Crenarchaeota 16S rRNA genes varied substantially over time but were well-correlated (r2=0.94, P<0.001) with ammonia monooxygenase subunit A (amoA) genes, and were more weakly related to 16S rRNA genes for all Archaea (r2=0.39), indicating that other archaeal groups (for example, Euryarchaeota) were numerically important. These data sets were compared with variability in bacterial community composition based on automated ribosomal intergenic spacer analysis (ARISA). We found that archaeal amoA gene copies and a SAR11 (or Pelagibacter) group Ib operational taxonomic unit (OTU) displayed strong co-variation through time (r2=0.55, P<0.05), and archaeal amoA and MG1 16S rRNA genes also co-occurred with two SAR86 and two Bacteroidetes OTUs. The relative abundance of these groups increased and decreased in synchrony over the course of the time series, and peaked during periods of seasonal transition. By using a combination of quantitative and relative abundance estimates, our findings show that abundant microbial OTUs—including the marine Crenarchaeota, SAR11, SAR86 and the Bacteroidetes—co-occur non-randomly; they consequently have important implications for our understanding of microbial community ecology in the sea.