The prevalence rates of refractive errors among children, adolescents, and adults in Germany

Sandra Jobke1, Erich Kasten2, Christian Vorwerk31Institute of Medical Psychology, 3Department of Ophthalmology, Otto-von Guericke-University of Magdeburg, Magdeburg, Germany; 2Institute of Medical Psychology, University Hospital Schleswig-Holstein, Luebeck, GermanyPurpose: The prevalence rates of myopia vary between 5% in Australian Aborigines to 84% in Hong Kong and Taiwan, 30% in Norwegian adults, and 49.5% in Swedish schoolchildren. The aim of this study was to determine the prevalence of refractive errors in German children, adolescents, and adults.Methods: The parents (aged 24–65 years) and their children (516 subjects aged 2–35 years) were asked to fill out a questionnaire about their refractive error and spectacle use. Emmetropia was defined as refractive status between +0.25D and –0.25D. Myopia was characterized as ≤−0.5D and hyperopia as ≥+0.5D. All information concerning refractive error were controlled by asking their opticians.Results: The prevalence rates of myopia differed significantly between all investigated age groups: it was 0% in children aged 2–6 years, 5.5% in children aged 7–11 years, 21.0% in adolescents (aged 12–17 years) and 41.3% in adults aged 18–35 years (Pearson’s Chi-square, p = 0.000). Furthermore, 9.8% of children aged 2–6 years were hyperopic, 6.4% of children aged 7–11 years, 3.7% of adolescents, and 2.9% of adults (p = 0.380). The prevalence of myopia in females (23.6%) was significantly higher than in males (14.6%, p = 0.018). The difference between the self-reported and the refractive error reported by their opticians was very small and was not significant (p = 0.850).Conclusion: In Germany, the prevalence of myopia seems to be somewhat lower than in Asia and Europe. There are few comparable studies concerning the prevalence rates of hyperopia.Keywords: Germany, hyperopia, incidence, myopia, prevalenc

Near-Death-Experiences: Between Spiritual Transmigration and Psychopathological Hallucinations

The research in the field of Near-Death-Experiences (NDE) shows us various reports of the process of dying which contradict the widely shared medical opinions in the past. Based on these observations, Raymond Moody developed and differentiated specific stages in the process of dying. Although these stages cannot be empirically proven, for some of the described stages scientific explanations can be found. For example, NDE have been reported in the terminal phase of life-threatening diseases, which can be explained by neurobiological changes of transmitter substances in dying person's brains. Further explanatory models fall back on other influences, e.g. side effects of sedative medication, psychedelic drugs, meditation, epilepsy, migraine or oneiroid psychosis. The large number of different visual experiences (tunnel vision, encounter with close relatives, bright lights, God, flowering gardens etc.) which appear in the course of a NDE, can be interpreted as visual hallucinations or oneiroid dreams as a consequence of medication or endogenous opioid production; in addition, a genetic predisposition could play an essential role. A NDE possibly is a final protective mechanism of the brain in agonizing patients, which leads to feelings of euphoria and experiences of hallucinations, caused by the explosive release of neurotransmitters. Positive emphasis should be given to the fact that in periods of increasing secularization the investigations of NDE have provided new hope of a life after death in the past 30 years. For many patients, caregivers, physicians and nurses, Moody's book was a great help in overcoming fears of dying and death. In spite of all legitimate criticism, the "nine elements of the Near-Death Experiences", still inspires researchers to have a different look on the process of dying

Psychological Stress In First Year Medical Students In Response To The Dissection Of A Human Corpse

Objectives: Gross anatomy is one of the most important and time consuming subjects in the first preclinical part of medical school in Germany. In October 2007 186 students started the dissection course at Otto-von-Guericke-University Magdeburg. The objective of this study is to analyze the emotional aspect relating to the gross anatomy course. In order to address this issue, we investigated how medical students experience the first confrontation and the following exposure to the dead bodies and whether there are any differences between various groups (age, gender, experience) of students

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

Training models and status of clinical neuropsychologists in Europe : results of a survey on 30 countries

PMID: 29923448Objective: The aims of the study were to analyze the current European situation of specialist education and training within clinical neuropsychology, and the legal and professional status of clinical neuropsychologists in different European countries. Method: An online survey was prepared in 2016 by a Task Force established by the European Federation of Psychological Associations, and representatives of 30 countries gave their responses. Response rate was 76%. Results: Only three countries were reported to regulate the title of clinical neuropsychologist as well as the education and practice of clinical neuropsychologists by law. The most common university degree required to practice clinical neuropsychology was the master’s degree; a doctoral degree was required in two countries. The length of the specialist education after the master’s degree varied between 12 and 60 months. In one third of the countries, no commonly agreed upon model for specialist education existed. A more systematic training model and a longer duration of training were associated with independence in the work of clinical neuropsychologists. Conclusions: As legal regulation is mostly absent and training models differ, those actively practicing clinical neuropsychology in Europe have a very heterogeneous educational background and skill level. There is a need for a European standardization of specialist training in clinical neuropsychology. Guiding principles for establishing the common core requirements are presented.Peer reviewe

Clinical Neuropsychology as a Specialist Profession in European Health Care : Developing a Benchmark for Training Standards and Competencies Using the Europsy Model?

The prevalence and negative impact of brain disorders are increasing. Clinical Neuropsychology is a specialty dedicated to understanding brain-behavior relationships, applying such knowledge to the assessment of cognitive, affective, and behavioral functioning associated with brain disorders, and designing and implementing effective treatments. The need for services goes beyond neurological diseases and has increased in areas of neurodevelopmental and psychiatric conditions, among others. In Europe, a great deal of variability exists in the education and training of Clinical Neuropsychologists. Training models include master's programs, continuing education courses, doctoral programs, and/or post-doctoral specialization depending on the country, with no common framework of requirements, although patients' needs demand equal competencies across Europe. In the past 5 years, the Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists' Association has conducted a series of surveys and interviews with experts in the field representing 30 European countries. The information, along with information from the existing literature, is used in presenting an overview of current and relevant topics related to policy and guidelines in the training and competencies in Clinical Neuropsychology. An option for the way forward is the EuroPsy Specialist Certificate, which is currently offered in Work and Organizational Psychology, and in psychotherapy. It builds upon the basic certificate and complements national standards without overriding them. General principles can be found that can set the basis for a common, solid, and comprehensive specialty education/training, sharpening the Neuropsychologists' competencies across Europe. The requirements in Clinical Neuropsychology should be comparable to those for the existing specialty areas in the EuroPsy model. Despite the perceived challenges, developing a specialist certificate appears a step forward for the development of Clinical Neuropsychology. Recommendations are proposed toward a shared framework of competencies by the means of a common level of education/training for the professionals in Europe. Benchmarking training standards and competencies across Europe has the potential of providing protection against unqualified and ethically questionable practice, creating transparency, raising the general European standard, and promoting mobility of both Clinical Neuropsychologists and patients in Europe, for the benefit of the professional field and the population.Peer reviewe

Core Competencies in Clinical Neuropsychology as a Training Model in Europe

The multitude of training models and curricula for the specialty of clinical neuropsychology around the world has led to organized activities to develop a framework of core competencies to ensure sufficient expertise among entry-level professionals in the field. The Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists' Associations is currently working toward developing a specialty certification in clinical neuropsychology to establish a cross-national standard against which to measure levels of equivalency and uniformity in competence and service provision among professionals in the field. Through structured interviews with experts from 28 European countries, we explored potential areas of core competency. Specifically, questions pertained to the perceived importance of a series of foundational, functional, and other competencies, as well as current training standards and practices, and optimal standards. Our findings revealed considerable agreement (about three quarters and above) on academic and clinical training, despite varied actual training requirements currently, with fewer respondents relegating importance to training in teaching, supervision, and research (a little over half), and even fewer to skills related to management, administration, and advocacy (fewer than half). European expert clinical neuropsychologists were in agreement with previous studies (including those conducted in the United States, Australia, and other countries) regarding the importance of sound theoretical and clinical training but management, administrative, and advocacy skills were not central to their perspective of a competent specialist in clinical neuropsychology. Establishing a specialty certificate in clinical neuropsychology based on core competencies may enable mobility of clinical neuropsychologists across Europe, and, perhaps, provide an impetus for countries with limited criteria to reconsider their training requirements and harmonize their standards with others.Peer reviewe

European Clinical Neuropsychology : Role in Healthcare and Access to Neuropsychological Services

This study analyzed aspects of the work of clinical neuropsychologists across Europe. There are no published comparisons between European countries regarding the nature of clinical neuropsychologists' work. Forty-one national psychological and neuropsychological societies were approached, of which 31 (76%) responded. Data from seven countries with less than 10 neuropsychologists were excluded. A license is required to practice clinical neuropsychology in 50% of the countries. Clinical neuropsychologists work independently in 62.5%. Diagnostic/assessment work is the most frequently reported activity (54%). Most neuropsychologists work in public hospitals, followed by health centers. Adult neuropsychology was the most frequent area of activity. Services in public institutions are covered by public entities (45.8%), or by a combination of patient funds and public entities (29.2%) and only 4.2% by the patient; whereas services in private institutions are covered by the patient (26.1%) and the combination of patient, public entities (21.7%) or patient and private entities (17.4%). The data suggest that the number of neuropsychologists working across European countries is considerably low in comparison to other medical professionals. The results of the survey identified similar aspects of neuropsychologists' work, despite variations in terms of reimbursement and mechanisms, reflecting economic and healthcare differences. Estimates on the number of clinical neuropsychologists suggest insufficient access to neuropsychological services.Peer reviewe

Multiethnic Societies of Central Asia and Siberia Represented in Indigenous Oral and Written Literature

Central Asia and Siberia are characterized by multiethnic societies formed by a patchwork of often small ethnic groups. At the same time large parts of them have been dominated by state languages, especially Russian and Chinese. On a local level the languages of the autochthonous people often play a role parallel to the central national language. The contributions of this conference proceeding follow up on topics such as: What was or is collected and how can it be used under changed conditions in the research landscape, how does it help local ethnic communities to understand and preserve their own culture and language? Do the spatially dispersed but often networked collections support research on the ground? What contribution do these collections make to the local languages and cultures against the backdrop of dwindling attention to endangered groups? These and other questions are discussed against the background of the important role libraries and private collections play for multiethnic societies in often remote regions that are difficult to reach