Der Effekt eines pflegegesteuerten Analgosedierungsprotokolls bei Kindern nach operativer Korrektur der Fallot´schen Tetralogie

In der vorliegenden monozentrischen retrospektiven Fallkontrollstudie wurde erstmals der Effekt eines pflegegesteuerten Analgesie- und Sedierungsprotokolls (pASP) für künstlich beatmete Kinder an einer homogenen Patientengruppe untersucht. Auf der pädiatrischen Intensivstation des Universitätsklinikums Tübingen wurde ein pflegegesteuertes pASP entwickelt, bestehend aus Algorithmen zur Analgesie, Sedierung und Entzug unter Anwendung der validierten COMFORT-B-Skala, dem NISS und dem SOS. Die Studie hatte zur Zielsetzung die Auswirkungen des pASP auf die Dauer der künstlichen Beatmung, die Dauer des Intensivaufenthalts, die Gesamt- und Maximaldosen von Benzodiazepinen, Opioiden und Alpha-2-Agonisten, sowie das Auftreten von Komplikationen und Entzugssymptomen bei Patienten nach erfolgter chirurgischer Korrektur des Herzfehlers Fallot-Tetralogie zu untersuchen. Durch die Implementierung des pASP konnte die mediane Aufenthaltsdauer auf der Intensivstation von 7 Tagen (Pre-Implementationsgruppe) auf 5 Tage (Post-Implementationsgruppe) signifikant reduziert werden. Ebenso waren die Gesamtdosis für Midazolam, sowie die applizierten Maximaldosen von Midazolam und Morphin nach Implementierung des pASP signifikant niedriger als in der Pre-Implementationsgruppe bei insgesamt im Zielbereich liegenden COMFORT-B Werten und NISS Werten. Gemäß den Ergebnissen dieser Studie ist die Anwendung eines pädiatrischen Analgosedierungsprotokolls in der postoperativen Behandlung von Säuglingen nach Korrektur einer Fallot’schen Tetralogie praktikabel und sicher und führte zu keiner Zunahme an Komplikationen. Die Ergebnisse dieser Studie stimmen zuversichtlich hinsichtlich der weiteren Verbreiterung und strukturierten Implementierung derartiger interdisziplinärer Analgosedierungsprotokolle in der pädiatrischen Intensivmedizin. Die vorliegende Studie sollte Stimulus sein für zukünftige Studien an größeren Kollektiven um die Ergebnisse derartiger pädiatrischer Sedierungsprotokolle zu bestätigen und gegebenenfalls auch weiter zu verbessern

Economic Recession Affects Gambling Participation But Not Problematic Gambling: Results from a Population-Based Follow-up Study

In October 2008, Iceland experienced the fastest and deepest financial crisis recorded in modern times when all three major banks went bankrupt in less than 2 weeks. The purpose of this follow-up study is to examine potential changes in participation in 12 different gambling types and in problem gambling before (time 1; year 2007) and after (time 2; year 2011) the economic collapse in 2008. The time between the first and second wave of data collection was 3.5 years. In total, 1,531 participants took part in the study, 688 males and 843 females. There was a considerable increase in past year gambling behavior from 2007 to 2011, mostly due to increased participation in lotto (National lotto and Viking lotto) but also in bingo, monthly lotteries (class lotteries with at least monthly draw) and scratch tickets. Only EGMs (electronic gaming machines) participation declined significantly between the two timepoints. Examining past year problematic gambling figures revealed that there were no changes in the prevalence figures between the year 2007 (1.2%) and 2011 (1.1%). Further examination revealed that those who reported financial difficulties due to the recession were more likely to buy lotto- or scratch tickets during the recession than those who were not financially affected by the crisis. These findings remained after controlling for background variables and baseline gambling activity (gambling in 2007). Overall, the findings of the follow-up study suggest that when people are experiencing financial difficulties during economic recessions, the possibility to improve their financial situation by winning large jackpots with low initial stakes becomes more enticing.This research project received funding from the Icelandic Ministry of the Interior. The authors have full responsibility for all parts of the data collection, examination of the data, and full control over the decision on publication.Peer Reviewe

Pressures to Publish: Catalysts for the Loss of Scientific Writing Integrity?

Publishing research is the final step in the scientific process and is used as the primary means for disseminating research findings to the scientific community. Publishing can embody many personal motivations (e.g., gratification, seeing a finished product in print, desire to further science) for authors as well as professional benefits (e.g., promotion, tenure, future funding opportunities). As the scientific workforce and competition for jobs and funding increase, publishing productivity has become a driving factor for many authors, which may lead to writing practices that violate integrity. In this essay, we discuss writing actions that may be considered a violation of integrity in the context of traditional manuscript sections (introduction and discussion, methods, and results). We define “integrity” as consistency of actions that reflect honesty and truthfulness. Writing the introduction and discussion can be compared to an artistic creation because the rendition of the data may vary depending on the intentions and experience of the author. Some authors may be tempted to relate their research to a hot topic (e.g., climate change, model selection) in an attempt to increase publication success or maximize visibility in search engines, despite not having sufficient data to support their conclusions. Caution must be taken to not overextend the “story” beyond the bounds of the data. Modification of the methods and results sections contains the most extreme cases of scientific integrity violations (e.g., changing an alpha level, only presenting positive results, running numerous tests until desired outcome). Manipulation of methods or results is more difficult to detect by peer review. We believe that however destructive integrity violations may be, despite benefits to the author (e.g., accolades, publication, potential citations, promotion, etc.), the individual scientist should hold him- or herself accountable and to a high standard to avoid sacrificing integrity. Presión para publicar: catalizadores de la pérdida de integridad en la publicación científica Resume: La publicación es la etapa final del proceso científico y se utiliza como el medio principal para diseminar los hallazgos de una investigación. Para los autores, publicar puede implicar distintas motivaciones tanto personales (p.e. satisfacción, ver un producto final impreso, deseo de hacer más ciencia) como profesionales (p.e. promoción interna, basificación, oportunidades de financiamiento). A medida que se incrementa la fuerza laboral científica y la competencia por trabajo y financiamiento, la productividad en cuanto a las publicaciones se ha convertido en un factor determinante para muchos autores, lo cual puede dar pie a prácticas de publicación que comprometen la integridad. En este ensayo se discuten aquellas prácticas de publicación que se considera que comprometen la integridad en el contexto de las secciones habituales que conforman un artículo (introducción y discusión, métodos y resultados). Se define la integridad como la consistencia en acciones que reflejan honestidad y veracidad. Escribir la introducción y discusión se compara con una creación artística en cuanto a que la interpretación de los datos puede variar dependiendo de las intenciones y experiencia del autor. Algunos autores pueden estar tentados a relacionar su investigación a un tópico de actualidad (p.e. cambio climático, selección de modelos) en un intento por incrementar el éxito de la publicación y maximizar la posibilidad de ser encontrados mediante motores de búsqueda, a pesar de que no cuentan con suficientes datos como para apoyar sus conclusiones. Se debe tener cuidado para no extender la historia más allá de los límites que establecen los datos. La modificación de las secciones de métodos y resultados implica los casos más extremos de violaciones a la integridad (p.e. cambiar el nivel de alfa, presentar sólo resultados positivos, realizar numerosas pruebas hasta que salga el resultado esperado). La manipulación de los métodos o los resultados resulta particularmente difícil de detectar durante el proceso de revisión por pares. Creemos que no obstante lo destructivas que puedan ser las violaciones a la integridad y a pesar de los beneficios que obtengan los autores (p.e. premios, potencial de citación, promociones, etc.), el individuo científico debe mantener su sentido de responsabilidad y sus estándares en alto con el fin de evitar sacrificar su integridad

Editorial: Problem Gambling: Summarizing Research Findings and Defining New Horizons

In 2003, Rachel A. Volberg wrote: “Why is it that gambling is not even on the radar when we consider the array of risks that adolescents must confront as they move towards adulthood?” Nowadays, after thirteen years, although much more is known about this particular form of risk behavior, there is still a general tendency, at least among laypersons, to not perceive gambling as a potential danger for youth and other population segments (e.g., individuals with migration background, seniors, sports professionals). However, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychological Association, 2013) included Gambling Disorder as the only condition in the Section Non-Substance-Related Disorders. Moreover, it is specified that the disorder can indeed occur in adolescence or young adulthood. Despite this fact, theoretical and applied research on problem gambling with regard to adolescence and other risk groups is still in its infancy. For this reason, it seems to be important to organize a Research Topic on gambling in Frontiers in Psychology in order to i) highlight the necessity of considering gambling as a potential harmful activity; ii) summarize the state-of-art of international research on different aspects of the topic; and iii) offer important novel findings relevant for advancing knowledge in the field of gambling. Different types of research articles will be provided including original articles, systematic/scoping reviews, meta-analyses, case reports, and commentaries. These contributions will be focused on the following most important areas in gambling research: Measurement (Which are the most widely used instruments to assess gambling-related problems as well as proximate constructs and what are their psychometric properties? Are there new instruments to detect adolescent problem gamblers?), Protective and risk factors (What do we know about ecological and individual influences on gambling behavior? Which factors affect problem gambling most and in which way?), Prevention (Which are the most promising prevention programs implemented until now? Which are necessary ingredients for effective prevention?), Treatment (When individuals seek help for their gambling-related problems, which are the clinical treatments that are offered? Do we have evidence for treatment effectiveness for different subgroups?). To try to fulfill this goal in the most comprehensive way, researchers from different countries and with specific competencies and interests will be contacted and encouraged to submit a contribution. Through the integration of international and multidisciplinary contributions, i) new challenges in the field of gambling will be identified (e.g., definition of specific at-risk groups, specification of effective interventions in terms of best practices) and ii) new research routes (e.g., the use of behavioral data) will be outlined in order to build a comprehensive understanding of problem gambling. The overall aim is to summarize the state of art, to propose original novel findings, and to outline new directions in gambling research

Seg1 controls eisosome assembly and shape

Eisosomes are stable domains at the plasma membrane of the budding yeast Saccharomyces cerevisiae and have been proposed to function in endocytosis. Eisosomes are composed of two main cytoplasmic proteins, Pil1 and Lsp1, that form a scaffold around furrow-like plasma membrane invaginations. We show here that the poorly characterized eisosome protein Seg1/Ymr086w is important for eisosome biogenesis and architecture. Seg1 was required for efficient incorporation of Pil1 into eisosomes and the generation of normal plasma membrane furrows. Seg1 preceded Pil1 during eisosome formation and established a platform for the assembly of other eisosome components. This platform was further shaped and stabilized upon the arrival of Pil1 and Lsp1. Moreover, Seg1 abundance controlled the shape of eisosomes by determining their length. Similarly, the Schizosaccharomyces pombe Seg1-like protein Sle1 was necessary to generate the filamentous eisosomes present in fission yeast. The function of Seg1 in the stepwise biogenesis of eisosomes reveals striking architectural similarities between eisosomes in yeast and caveolae in mammals

Internet self-exclusion: Characteristics of selfexcluded gamblers and preliminary evidence for its effectiveness

Abstract Preliminary scientific evidence indicates that online gamblers are more likely to be problem gamblers and thus point to the need for effective protection measures. This study focuses on an online self-exclusion program and seeks to comprehensively examine the benefits of this measure. It was intended to collect detailed information on the characteristics of self-excluded internet gamblers and to examine the benefits of online selfexclusion over time. The baseline sample consisted of a total of N=259 internet gamblers who self-excluded from the online gambling platform win2day.at. Descriptive analyses indicate that a significant percentage of respondents had gambled excessively on the internet. Follow-up surveys 1, 6, and 12 month(s) after the initiation of self-exclusion with a small sub-sample (n=20) suggest that the temporary restriction of access to one single online gambling site can indeed have favorable psycho-social effects. The article concludes with a discussion of how self-exclusion practices on the internet can be improved

Schadensbegrenzung beim Glücksspiel

Hintergrund: Die Verfügbarkeit von Glücksspielen ist in Deutschland seit Mitte der 1970er-Jahre stark gestiegen. Als Reaktion auf potenzielle Folgeschäden dieses Entwicklungstrends wurden von industrieller und staatlicher Seite Maßnahmen eines verantwortungsbewussten Umgangs mit Glücksspielen (Responsible Gambling) ergriffen. Kritische Analysen dieses Präventionsansatzes verweisen alternativ auf ein Konzept der öffentlichen Gesundheitsfürsorge (Public Health). Fragestellung: Vor dem Hintergrund des neuen Glücksspielstaatsvertrags, der am 01. Juli 2021 in Kraft getreten ist, stellt sich die Frage, wie die beiden Ansätze einzuordnen und hinsichtlich einer effektiven Schadensbegrenzung zu bewerten sind. Methode: Im Zuge eines narrativen Reviews erfahren die Kernaussagen dieser beiden Ansätze eine kritische Analyse. Ergebnisse: Das Konzept des verantwortungsbewussten Umgangs mit Glücksspielen fokussiert primär auf die individuelle Verantwortung und Vulnerabilität der Spieler*innen. Verhältnispräventive Maßnahmen, wie die Reduktion der Verfügbarkeit, Beschränkungen der Spielanreize durch Eingriffe in die Spielstruktur und Werberestriktionen, die Interessenkonflikte der Anbieter hervorrufen, fehlen weitgehend. Der interdisziplinäre Public-Health-Ansatz ist breiter ausgerichtet und berücksichtigt neben individuellen Risikofaktoren zielgenauer soziale, umweltbezogene und wirtschaftliche Faktoren, die zusammen mit der Identifizierung schädlicher Eigenschaften des Produkts 'Glücksspiel' zu einer umfassenden Präventionsstrategie führen. Schlussfolgerung: Neue Erkenntnisse in den Bereichen Forschung und Praxis sowie die zunehmende Akzeptanz evidenzbasierter Public-Health-Strategien wecken Hoffnungen, dass dieser Weg zukünftig auch in Deutschland beschritten wird

Multi-venue exclusion program and early detection of problem gamblers: What works and what not?

Since April 2014, a multi-venue exclusion program exists in the federal state of Hesse (Germany) that covers all gambling arcades with AWP-machines. In addition, the operators are obliged by legislation to exclude gambling-addicted or excluded individuals from gambling and to train the staff in the early detection of problem gambling. The present research has two objectives: to analyze the dataset of all excluded individuals in Hesse (N = 12,253) with regard to core sociodemographic variables and to check the staff compliance with regard to the implementation of player protection measures by covert test purchases. For the second purpose, students visited 64 of the 750 Hessian gambling arcades. The results of the database analyses show that only about 1% of all exclusions have been initiated by third parties (e.g., operators). The excluded gamblers were mainly male (87.7%), and a large number of individuals had a migration background (46.6%). Furthermore, the test purchases revealed that in 16.4% of all attempts, no entrance control was carried out. In 28.1% of all gambling arcades, the subjects were able to gambling despite an active self-exclusion. Finally, staff responded in only 7.3% of all cases with appropriate interventions when being confronted with problematic gambling patterns. In general, the establishment of a multi-venue exclusion program can thus be recommended due to several reasons (e.g., considerable acceptance by high risk-groups). However, several shortcomings with regard to staff compliance call for a more consistent monitoring of the implementation of legally required measures for player protection in situ