21 research outputs found
Results from the Randomized Controlled Multicenter German Algorithm Project 3 Trial
Background Treatment algorithms are considered as key to improve outcomes by
enhancing the quality of care. This is the first randomized controlled study
to evaluate the clinical effect of algorithm-guided treatment in inpatients
with major depressive disorder. Methods Inpatients, aged 18 to 70 years with
major depressive disorder from 10 German psychiatric departments were
randomized to 5 different treatment arms (from 2000 to 2005), 3 of which were
standardized stepwise drug treatment algorithms (ALGO). The fourth arm
proposed medications and provided less specific recommendations based on a
computerized documentation and expert system (CDES), the fifth arm received
treatment as usual (TAU). ALGO included 3 different second-step strategies:
lithium augmentation (ALGO LA), antidepressant dose-escalation (ALGO DE), and
switch to a different antidepressant (ALGO SW). Time to remission (21-item
Hamilton Depression Rating Scale ≤9) was the primary outcome. Results Time to
remission was significantly shorter for ALGO DE (n=91) compared with both TAU
(n=84) (HR=1.67; P=.014) and CDES (n=79) (HR=1.59; P=.031) and ALGO SW (n=89)
compared with both TAU (HR=1.64; P=.018) and CDES (HR=1.56; P=.038). For both
ALGO LA (n=86) and ALGO DE, fewer antidepressant medications were needed to
achieve remission than for CDES or TAU (P<.001). Remission rates at discharge
differed across groups; ALGO DE had the highest (89.2%) and TAU the lowest
rates (66.2%). Conclusions A highly structured algorithm-guided treatment is
associated with shorter times and fewer medication changes to achieve
remission with depressed inpatients than treatment as usual or computerized
medication choice guidance
Fragmentiertes Klassenbewusstsein? Zur subjektiven Dimension kapitalistischer Landnahmen
Neue Medien als Bildungsfaktoren in außerschulischen Sozialisationspozessen
Treumann KP, Strake (u.a.) G. Neue Medien als Bildungsfaktoren in außerschulischen Sozialisationspozessen. Erziehung und Bildung als öffentliche Aufgabe. Beiträge zum 11. Kongreß der Deutschen Gesellschaft für Erziehungswissenschaft vom 21.-23.03.1988 in Saarbrücken. Beltz, 23. Beiheft der Zeitschrift für Pädagogik. 1988:233-238