251 research outputs found
Conceptualisation and measurement of quality of life based on Schalock & Verdugo's model : a cross-disciplinary review of the literature
Paarbeziehungen als Mikrosysteme: Ableitung und empirische Prüfung von theoretischen Annahmen
"Im Zentrum dieser Arbeit stehen zwei Fragen: 1. Hilft eine systemtheoretische Meta-Perspektive, um die eher a-theoretische Forschung bei den Paarbeziehungen zu überwinden und 2. gibt es kritische Anfangszustände, die eine Paarbeziehung stabilisieren? In einer Untersuchung an 344 Paaren werden die Merkmale auf systemtheoretischem Hintergrund analysiert, die beim Verlieben auf eine dauerhaft glückliche Beziehung schließen lassen. Dabei zeigt sich, dass vor allem die Übereinstimmung zwischen den Partnern beim Verlieben in den beiden Bereichen emotionale Bindung und soziale Integration dazu führen, dass sich diese Paare von anderen Paaren mit geringerer Stabilität (Dauer und Glück) unterscheiden lassen. Der Ausgangspunkt des Mikrosystems ist damit eine Bedingung für die Entwicklung einer langen und glücklichen Beziehung oder deren Instabilität. Unter dieser theoretischen Annahme, dass Übereinstimmungen in nicht sichtbaren Kriterien in der Phase des Verliebens relevant für die Stabilität sind, lassen sich die hohen Trennungs- und Scheidungsraten von ca. 50 Prozent erklären bzw. bestätigen diese Annahme, wenn andere Bindungsmomente wegfallen." (Autorenreferat)"This study focusses on two questions: 1. Can a system-oriented meta-perspective help to overcome the atheoretical research in the field of relationships and 2. are there critical states in the beginning of the relationship that can make it more stable? In a study of 344 couples we analyse the characteristics on a system-oriented basis that suggest a happy lasting relationship when falling in love. Stable and unstable (lasting and happiness) relationships differ in respect to the variables emotional bond and social integration. We found the partnership answers to be more corresponding in stable relationships whereas in unstable relationships the answers differ. This means that the starting point of the micro system already is critical for a long and happy relationship. Theoretical assumption, that invisible similarity in the beginning, is relevant for stability , explains the high rate of separation and divorce of 50% if there are no other pressures to stay in the relationship as financial or other support. The high rate of separation and divorce supports this theory also." (author's abstract
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Health related quality of life of immigrant children: towards a new pattern in Germany?
Background: To study Health related quality of life (HRQoL) of a sample of kindergarten children with migration background. Methods: Five kindergartens in Frankfurt/Main and Darmstadt (Germany) participated. HRQoL was measured with the Kiddy-KINDL (KK) in 3 to 5 year old children. We examined the associations of HRQoL with socio-demographic variables, positive development and resilience, socio-emotional and motor development. Linear regression models were applied to examine differences in HRQoL between migrant and native-born German children. Results: The response rate was 90.5% (N = 283). The children had predominantly migrant background (81.35%). Perceived health was slightly higher in migrants (69.85, SD 17.00) compared to native-born German children (68.33, SD 17.31, p > 0.05), even though migrant children were characterized by a lower socio-economic status (p < 0.01). Conclusions: Results suggest that HRQoL at early ages in our study exhibits a different pattern than reported previously in studies among older individuals. We attribute the discrepancy partly to a possible changing pattern of migration in Europe with more migrants capable to migrate with healthy profiles, and to the age of our population. Our findings underscore the need to study the life course trajectory of HRQoL among young immigrants and replication in representative samples
Pediatric Health-Related Quality of Life:A Structural Equation Modeling Approach
Objectives: One of the most referenced theoretical frameworks to measure Health Related Quality of Life (HRQoL) is the Wilson and Cleary framework. With some adaptions this framework has been validated in the adult population, but has not been tested in pediatric populations. Our goal was to empirically investigate it in children.Methods: The contributory factors to Health Related Quality of Life that we included were symptom status (presence of chronic disease or hospitalizations), functional status (developmental status), developmental aspects of the individual (social-emotional) behavior, and characteristics of the social environment (socioeconomic status and area of education). Structural equation modeling was used to assess the measurement structure of the model in 214 German children (3-5 years old) participating in a follow-up study that investigates pediatric health outcomes.Results: Model fit was chi(2) = 5.5; df = 6; p = 0.48; SRMR = 0.01. The variance explained of Health Related Quality of Life was 15%. Health Related Quality of Life was affected by the area education (i.e. where kindergartens were located) and development status. Developmental status was affected by the area of education, socioeconomic status and individual behavior. Symptoms did not affect the model.Conclusions: The goodness of fit and the overall variance explained were good. However, the results between children' and adults' tests differed and denote a conceptual gap between adult and children measures. Indeed, there is a lot of variety in pediatric Health Related Quality of Life measures, which represents a lack of a common definition of pediatric Health Related Quality of Life. We recommend that researchers invest time in the development of pediatric Health Related Quality of Life theory and theory based evaluations.</p
Presence of broad-spectrum beta-lactamase-producing Enterobacteriaceae in zoo mammals
Broad-spectrum beta-lactamase (BSBL)-producing Enterobacteriaceae impose public health threats. With increased popularity of zoos, exotic animals are brought in close proximity of humans, making them important BSBL reservoirs. However, not much is known on the presence of BSBLs in zoos in Western Europe. Fecal carriage of BSBL-producing Enterobacteriaceae was investigated in 38 zoo mammals from two Belgian zoos. Presence of bla-genes was investigated using PCR, followed by whole-genome sequencing and Fourier-transform infrared spectroscopy to cluster acquired resistance encoding genes and clonality of BSBL-producing isolates. Thirty-five putatively ceftiofur-resistant isolates were obtained from 52.6% of the zoo mammals. Most isolates were identified as E. coli (25/35), of which 64.0% showed multidrug resistance (MDR). Most frequently detected bla-genes were CTX-M-1 (17/25) and TEM-1 (4/25). Phylogenetic trees confirmed clustering of almost all E. coli isolates obtained from the same animal species. Clustering of five isolates from an Amur tiger, an Amur leopard, and a spectacled bear was observed in Zoo 1, as well as for five isolates from a spotted hyena and an African lion in Zoo 2. This might indicate clonal expansion of an E. coli strain in both zoos. In conclusion, MDR BSBL-producing bacteria were shown to be present in the fecal microbiota of zoo mammals in two zoos in Belgium. Further research is necessary to investigate if these bacteria pose zoonotic and health risks
General practitioner-centred paediatric primary care reduces risk of hospitalisation for mental disorders in children and adolescents with ADHD: findings from a retrospective cohort study
Background: General practitioners (GPs) play an essential role in the sustainable management of attention-deficit/hyperactivity disorder (ADHD). To our knowledge, the healthcare programme described here is the first integrated care programme for paediatric ambulatory care embedded in GP-centred-healthcare in Germany.
Objectives: To compare the health-service-utilisation of patients with ADHD enrolled in a GP-centred-paediatric-primary-care-programme with usual care in terms of disease-related hospitalisation, pharmacotherapy and psychotherapy.
Methods: In 2018, we conducted a retrospective cohort study of 3- to 18-year-old patients with ADHD in Baden-Wuerttemberg, southern Germany. The intervention group (IG) comprised patients enrolled in a GP-centred-paediatric-primary-healthcare-programme and consulted a participating GP for ADHD at least once. GP-centred-paediatric-primary-care provides high continuity of care, facilitated access to specialist care, extended routine examinations and enhanced transition to adult healthcare. Patients in the control group (CG) received usual care, meaning they consulted a non-participating GP for ADHD at least once. Main outcomes were disease-related hospitalisation, pharmacotherapy and psychotherapy. Multivariable logistic regression was performed to compare groups.
Results: A total of 2317 patients were included in IG and 4177 patients in CG. Mean age was 8.9 ± 4.4. The risk of mental-disorder-related hospitalisations was lower in IG than CG (odds ratio (OR): 0.666, 95% confidence interval (CI): 0.509-0.871). The prescription rate for stimulants was lower in IG (OR: 0.817; 95% CI: 0.732-0.912). There was no statistically significant difference in the participation rate of patients in cognitive behavioural therapy between groups (OR: 0.752; 95% CI: 0.523-1.080).
Conclusion: Children and adolescents with ADHD enrolled in GP-centred-paediatric-primary-care are at lower risk of mental-disorder-related hospitalisation and less likely to receive stimulants.
Keywords: ADHD; claims data; health-care-utilisation; multivariate analysis; primary care
Paraoxonase 2 protein is spatially expressed in the human placenta and selectively reduced in labour
Humans parturition involves interaction of hormonal, neurological, mechanical stretch and inflammatory pathways and the placenta plays a crucial role. The paraoxonases (PONs 1–3) protect against oxidative damage and lipid peroxidation, modulation of endoplasmic reticulum stress and regulation of apoptosis. Nothing is known about the role of PON2 in the placenta and labour. Since PON2 plays a role in oxidative stress and inflammation, both features of labour, we hypothesised that placental PON2 expression would alter during labour. PON2 was examined in placentas obtained from women who delivered by cesarean section and were not in labour and compared to the equivalent zone of placentas obtained from women who delivered vaginally following an uncomplicated labour. Samples were obtained from 12 sites within each placenta: 4 equally spaced apart pieces were sampled from the inner, middle and outer placental regions. PON2 expression was investigated by Western blotting and real time PCR. Two PON2 forms, one at 62 kDa and one at 43 kDa were found in all samples. No difference in protein expression of either isoform was found between the three sites in either the labour or non-labour group. At the middle site there was a highly significant decrease in PON2 expression in the labour group when compared to the non-labour group for both the 62 kDa form (p = 0.02) and the 43 kDa form (p = 0.006). No spatial differences were found within placentas at the mRNA level in either labour or non-labour. There was, paradoxically, an increase in PON2 mRNA in the labour group at the middle site only. This is the first report to describe changes in PON2 in the placenta in labour. The physiological and pathological significance of these remains to be elucidated but since PON2 is anti-inflammatory further studies are warranted to understand its role
De novo Assembly of the Burying Beetle Nicrophorus orbicollis (Coleoptera: Silphidae) Transcriptome Across Developmental Stages with Identification of Key Immune Transcripts
Burying beetles (Nicrophorus spp.) are among the relatively few insects that provide parental care while not belonging to the eusocial insects such as ants or bees. This behavior incurs energy costs as evidenced by immune deficits and shorter life-spans in reproducing beetles. In the absence of an assembled transcriptome, relatively little is known concerning the molecular biology of these beetles. This work details the assembly and analysis of the Nicrophorus orbicollis transcriptome at multiple developmental stages. RNA-Seq reads were obtained by next-generation sequencing and the transcriptome was assembled using the Trinity assembler. Validation of the assembly was performed by functional characterization using Gene Ontology (GO), Eukaryotic Orthologous Groups (KOG), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Differential expression analysis highlights developmental stage-specific expression patterns, and immunity-related transcripts are discussed. The data presented provides a valuable molecular resource to aid further investigation into immunocompetence throughout this organism’s sexual development
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HIV Prevention for Intimate Couples: A Relationship-Based Model
HIV prevention programs targeted to heterosexuals have most often been delivered in individual or group modalities that principally focus on women as the agents of change. To date, most HIV risk-reduction interventions are not specifically designed to address issues involving intimate couples or to include both partners. Approaches which take into account relationship dynamics and communication patterns are needed to enable women to initiate or sustain condom use with their main steady partners. In this paper, we present a relationship-based HIV intervention, Project Connect, delivered to 217 African American and Latino heterosexual couples recruited from primary healthcare settings. The paper will first discuss the rationale and the conceptual framework underlying the intervention and then elaborate on the intervention components. Finally, lessons learned in the implementation of the project and implications of Project Connect to future practice and policy making for HIV interventions for heterosexual couples will be discussed
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