The German EMPATHIC-30 questionnaire showed reliability and convergent validity for use in an intermediary/general pediatric cardiology unit: a psychometric evaluation

Education and Child Studie

Family-Centered Care at Pediatric Cardiac Intensive Care Units in Germany and the Relationship with Parent and Infant Well-Being: A Study Protocol

Rationale and Aim: Infants with Congenital Heart Disease (CHD) are at risk for neurodevelopmental delays, emotional, social and behavioral difficulties. Hospitalization early in life and associated stressors may contribute to these challenges. Family-centered Care (FCC) is a health care approach that is respectful of and responsive to the needs and values of a family and has shown to be effective in improving health outcomes of premature infants, as well as the mental well-being of their parents. However, there is limited empirical data available on FCC practices in pediatric cardiology and associations with parent and infant outcomes. Methods and Analysis: In this cross-sectional study, we will explore FCC practices at two pediatric cardiac intensive care units in Germany, assess parent satisfaction with FCC, and investigate associations with parental mental well-being and parenting stress, as well as infant physical and mental well-being. We will collect data of 280 infants with CHD and their families. Data will be analyzed using multivariate statistics and multilevel modeling. Implications and Dissemination: The study protocol was approved by the medical ethics committees of both partner sites and registered with the German registry for clinical trials (NR DRKS00023964). This study serves as a first step to investigate FCC practices in a pediatric cardiology setting, providing insight into the relationship between FCC and parent and infant outcomes in a population of infants with CHD. Results will be disseminated in peer-reviewed journals

Der Kampf mit dem Gewicht: Cognitive Bias Modification bei Übergewichtigen

Item does not contain fulltextEinleitung: Programme zur Gewichtsreduktion sind bislang wenig erfolgreich. Als Ursache hierfür wird vermutet, dass Essgewohnheiten einen ähnlich hohen Automatisierungsgrad aufweisen wie Suchtverhaltensweisen (Kakoschke et al., 2017). Wir haben untersucht, ob das in der Behandlung von Alkoholabhängigen erfolgreiche Trainingsprogramm zur Überwindung automatisierter Annäherungstendenzen (u.a. Wiers et al., 2011) als Zusatzangebot einen Vorteil für Übergewichtige bei der Gewichtsreduktion hat. Methodik: Probanden waren 189 übergewichtige Patienten (BMI > 29,5) in stationärer Psychosomatikbehandlung, die an einem Programm zur Gewichtsreduktion teilnahmen. Die Probanden wurden zufällig für jeweils 6 Sitzungen à 15 Minuten mit jeweils 220 Trainingsdurchgängen auf ein Vermeidungs-Training oder ein Scheintraining verteilt. Beim Vermeidungs-Training hatten die Probanden die Aufgabe, Bilder von kalorienreichen Lebensmitteln auf dem Bildschirm mithilfe eines Joysticks wegzudrücken (Vermeidung) und Bilder von leichter körperlicher Aktivität heranzuziehen (Annäherung). Beim Scheintraining mussten die Probanden alle Bilder unabhängig vom Bildinhalt mit dem Joystick ebenso häufig wegdrücken wie heranziehen. Zur Ermittlung von kurzfristigen Trainingseffekten wurden die Annäherungstendenz, implizite essensspezifische Assoziationen und der Body-Mass-Index vor Beginn und nach Abschluss aller Trainingseinheiten gemessen. Ergebnisse: Entsprechend unserer Hypothese verbesserte sich die Annäherungs-Vermeidungs-Tendenz in der Vermeidungs-Trainingsgruppe signifikant im Vergleich zum Scheintraining dergestalt, dass die Probanden nach Abschluss des Vermeidungs-Trainings die hochkalorischen Essensbilder schneller wegdrücken und die leichten Bewegungsbilder schneller heranziehen konnten. Außerdem generalisierte dieser inhaltsspezifische Effekt auf ähnliche Abbildungen, mit denen nicht trainiert worden war. Dagegen zeigte sich kurzfristig kein Unterschied zwischen Vermeidungs- und Scheintraining hinsichtlich einer impliziten essensspezifischen, positiven Assoziationstendenz oder hinsichtlich des Body-Mass-Index. Schlussfolgerung: Die Ergebnisse deuten darauf hin, dass mithilfe eines ernährungsspezifischen Annäherungs-Vermeidungstrainings die automatisierte Essensannäherungstendenz von Übergewichtigen kurzfristig überwunden werden kann. Künftigen Studien bleibt allerdings vorbehalten zu untersuchen, ob auf diese Weise langfristig das Ernährungs- und Bewegungsverhalten von Übergewichtigen günstig beeinflusst werden kann.1 p

Retraining of automatic action tendencies in individuals with obesity: A randomized controlled trial

Contains fulltext : 189404.pdf (publisher's version ) (Closed access)Obesity is a major health concern, characterized by an automatically activated tendency to (over)-eat. Recent research suggests that an effective way to counteract automatic approach tendencies in unhealthy consumption behavior might be approach bias modification. Therefore, we investigated an approach-avoidance training for unhealthy food cues in 189 patients with obesity of a psychosomatic inpatient clinic who were participating in a nutrition advice program. Patients in the active training group were trained to make avoidance movements (pushing a joystick) in response to unhealthy food pictures and approach movements (pulling the joystick) in response to positive pictures, while the control group received sham training (approaching and avoiding both picture types). Approach-avoidance bias, body mass index, eating pathology and food-specific implicit associations were assessed before and after the training. In line with our hypothesis, approach-avoidance bias improved in the active training group after the training, in comparison to the sham training group. Moreover, this effect generalized to new, untrained stimuli. However, no effects of the training were found in a food-specific Single-Target Implicit Association Test, or on eating pathology questionnaires or body mass index. While the training results are promising, the effect of approach-avoidance bias modification on relevant behavior in obesity has yet to be established before it may be implemented as an add-on treatment.7 p

Retraining of automatic action tendencies in individuals with obesity: A randomized controlled trial

Contains fulltext : 189404.pdf (publisher's version ) (Closed access)Obesity is a major health concern, characterized by an automatically activated tendency to (over)-eat. Recent research suggests that an effective way to counteract automatic approach tendencies in unhealthy consumption behavior might be approach bias modification. Therefore, we investigated an approach-avoidance training for unhealthy food cues in 189 patients with obesity of a psychosomatic inpatient clinic who were participating in a nutrition advice program. Patients in the active training group were trained to make avoidance movements (pushing a joystick) in response to unhealthy food pictures and approach movements (pulling the joystick) in response to positive pictures, while the control group received sham training (approaching and avoiding both picture types). Approach-avoidance bias, body mass index, eating pathology and food-specific implicit associations were assessed before and after the training. In line with our hypothesis, approach-avoidance bias improved in the active training group after the training, in comparison to the sham training group. Moreover, this effect generalized to new, untrained stimuli. However, no effects of the training were found in a food-specific Single-Target Implicit Association Test, or on eating pathology questionnaires or body mass index. While the training results are promising, the effect of approach-avoidance bias modification on relevant behavior in obesity has yet to be established before it may be implemented as an add-on treatment.7 p

The German EMPATHIC-30 Questionnaire Showed Reliability and Convergent Validity for Use in an Intermediary/General Pediatric Cardiology Unit: A Psychometric Evaluation.

Background: Family-Centered Care is a useful framework for improving care for hospitalized children with congenital heart disease. The EMpowerment of PArents in THe Intensive Care-30 (EMPATHIC-30) questionnaire is a widely accepted tool to measure parental satisfaction with Family-Centered Care. Psychometric properties of the EMPATHIC-30 have been evaluated in neonatal and pediatric intensive care units, but not in pediatric cardiac care units. Therefore, our aim was to assess the psychometric properties of the German EMPATHIC-30 in an intermediary/general pediatric cardiology unit. Methods: We used data from a quality management survey comprising the German EMPATHIC-30, a sociodemographic questionnaire and four general satisfaction items. Data were collected at the intermediary/general pediatric cardiology unit of a specialized heart center in Germany (n = 366). We split the data randomly into two subsets. In the first subset, we assessed internal consistency reliability with McDonald's omega and Cronbach's alpha, and convergent validity using Spearman's rank correlation. Furthermore, we explored the internal structure with Principal Component Analysis (PCA). In the second subset, we validated the resulting structure using Confirmatory Factor Analysis (CFA). Results: The reliability estimates exceeded 0.70 for all five domain scores and 0.90 for the full-scale score. Convergent validity between EMPATHIC-30 domain scores/ the full-scale score and the four general satisfaction items was adequate (rs = 0.40-0.74). The PCA suggested three components, accounting for 56.8% of the total variance. Cross-validation via CFA showed poor model fit (χ2 = 1545.78, χ2/df = 3.85, CFI = 0.70, TLI = 0.66, RMSEA = 0.13), indicating that the EMPATHIC-30 shows no clear and generalizable factor structure in this sample. Discussion: The German version of the EMPATHIC-30 exhibited reasonable psychometric properties in an intermediary/general pediatric cardiology unit. Follow-up studies should investigate the factor structure of the EMPATHIC-30 in other pediatric inpatient care settings

Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior anti hypertensive therapy, in acute stroke: rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial

High blood pressure (BP) is common in acute stroke and is independently associated with a poor outcome. Many patients with acute stroke are taking antihypertensive medications. To test the safety and efficacy of 7 days of transdermal glyceryl trinitrate (GTN, 5 mg/day) vs. no GTN in patients with acute stroke; patients taking antihypertensive therapy immediately before their stroke are also randomised to continue vs. stop this temporarily. ENOS is a prospective international multicentre single-blind randomised-controlled trial in 5000 patients with acute (<48 h of onset) ischaemic or haemorrhagic stroke. The primary outcome is combined death and dependency (modified Rankin scale >2) at 90 days measured by blinded central telephone follow-up. Secondary outcomes include: BP over the 7 days of treatment; death, impairment (Scandinavian stroke scale), recurrence, and neuroimaging at 7 days; discharge disposition, disability (Barthel index), cognition (mini-mental status examination) and quality of life (EuroQoL). The sample size will allow an absolute difference in death/dependency of 5% to be detected with 90% power at 5% significance for GTN versus no GTN. Randomisation and data collection are performed over a secure Internet site with real-time data validation. Neuroimaging and serious adverse events are adjudicated blinded to treatment