Prediction and trend of tactile acuity, pain and disability in acute LBP : a six-month prospective cohort study

Background: Chronic back pain is known to be associated with altered tactile acuity. Tactile acuity is measured using the Two-Point Discrimination (TPD) test in both clinical and research settings. In subjects with chronic low back pain, the TPD threshold (TPDT) is increased and is associated with persistent pain. It remains unknown, however, whether TPDT is also altered in cases of clinical acute pain, or whether it could be used as a predictor of future pain and disability at an early stage of LBP. The main objective of this study was to investigate the predictive value of baseline TPDT for pain and disability at 3 and 6 months after the onset of acute LBP. The TPDT in acute low back pain (LBP) and the development of TPDT over 6 months has also been assessed. Methods: LBP participants (n = 124) with acute LBP (< 4 weeks) were included. Subjects were examined within 4 weeks of pain onset and followed-up after 3 and 6 months of pain onset. Horizontal and vertical TPDTs of the lower back were collected. Linear mixed models were subsequently used to evaluate the association of TPDT with pain and disability over time. Results: The vertical TPDT showed a mean (SD) of 4.9 cm (1.6) and the horizontal TPDT a mean (SD) of 6.0 cm (1.5) at baseline. The vertical TPDT altered from baseline up to 6 months from 4.9 to 4.6 cm and the horizontal TPDT from 6.0 to 5.4 cm. The association between the TPDT and the Oswestry Disability Index (ODI) after 6 months was moderate. Linear mixed models revealed no association between TPDT, pain and disability over the progression of LBP. Conclusion: TPDTs appear to be raised in subjects with acute LBP. However, our study revealed no predictive capability of the TPDT for disability and pain. No comparisons are possible in the absence of similar studies, indicating the need for further research is in this area

Factors affecting the acculturation strategies of unaccompanied refugee minors in Germany

BackgroundDifferent acculturation strategies might be related to different mental health outcomes and social participation of unaccompanied refugee minors (URMs), but little is known about which factors influence this acculturation process. Therefore, the aim of this investigation was to examine the impact of individual, stress-related, and contextual factors on the acculturation process of URMs in Germany.MethodsA sample of N = 132 URMs living in child and youth welfare service facilities in Germany completed questionnaires about their acculturation orientation, traumatic experiences, daily stressors, asylum stress, and perceived social support between June 2020 and October 2021. This investigation is part of the multi-center randomized control trial BETTER CARE. Data were analyzed descriptively and via multiple hierarchical regression.ResultsIntegration (43.5%) and Assimilation (37.1%) were the most common acculturation strategies used by URMs. Multiple hierarchical regression models showed that daily stressors (e.g., the lack of money) were associated with a stronger orientation toward the home country, whereas traumatic events were associated with a weaker orientation toward their home country. No significant predictors were found for the orientation toward the host country.DiscussionOverall, URMs in Germany showed favorable acculturation strategies. Nevertheless, daily stressors and traumatic experiences might influence this process. The implications for practitioners and policymakers are discussed with a view to further improving the acculturation process of URMs in Germany.Clinical Trial Registration: German Clinical Trials Register, DRKS00017453 https://drks.de/search/de/trial/DRKS00017453. Registered on December 11, 2019

Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety–A secondary analysis of the Better Care study

BackgroundUnaccompanied young refugees (UYRs) show elevated levels of mental distress such as post-traumatic stress symptoms (PTSS), depression, and anxiety. The individual post-arrival situation in the host country plays an important role in increasing or reducing mental health risks for these vulnerable children and youth. The study aims at examining the impact of pre- and post-migration factors on the mental health of UYRs.MethodsA cross-sectional survey of N = 131 young refugees (81.7% male, M = 16.9 years old) was conducted in 22 children and youth welfare service (CYWS) facilities in Germany. The participants provided information about pre- and post-flight experiences. Standardized measures were used to assess post-traumatic stress symptoms (CATS-2), symptoms of depression (PHQ-9), and anxiety (GAD-7). Daily stressors were assessed with the Daily Stressors Scale for Young Refugees (DSSYR), sociocultural adaptation with the Brief Sociocultural Adaptation Scale (BSAS), satisfaction with social support with the Social Support Questionnaire (SSQ6-G).ResultsOur results demonstrated clinical levels of PTSS in 42.0% of the participants, depression in 29.0%, and anxiety in 21.4%. Hierarchical regression analyses revealed that a higher number of traumatic events and social daily stressors predicted higher levels in all three domains of mental health problems. PTSS and anxiety were also predicted by the distress related to the residence status, depressive symptoms were additionally predicted by sociocultural adaptation, less family contact and length of stay. The satisfaction with social support was not a significant predictor in the regression models.ConclusionUnaccompanied young refugees in CYWS facilities are a highly vulnerable population. As traumatic events, daily stressors and level of contact to family directly impacted UYRs mental health, interventions should be trauma-focused, but also contain modules on how to cope with daily stressors. On the policy and practical level, stakeholders in host countries are called for establishing measures to reduce post-migration stressors and enhance support for UYRs on all levels

Evaluierung und Optimierung biologischer Verfahren zur Regulierung des Pflaumenwicklers (Cydia funebrana) und der Monilia-Krankheit im ökologischen Steinobstanbau

Im Verbundforschungsprojekt FKZ 06OE198, FKZ 06OE057 und FKZ 06OE348 wurden Möglichkeiten der Regulierung des Pflaumenwicklers (Cydia funebrana) an Zwetschgen in Labor-, Halbfreiland und Freilandversuchen in Geisenheim, Darmstadt, Klein-Altendorf und Weinsberg untersucht. Labor- und Freilandversuche zur Regulierung der Monilia-Krankheit wurden in Geisenheim, Weinsberg und Dresden durchgeführt. Sauerkirschsorten-Versuche sind in Weinsberg und Dresden aufgepflanzt. Umfangreiche Freilandversuche zur Verwirrung des Pflaumenwicklers mit „Isomate OFM Rosso“ in Baden-Württemberg und Rheinland-Pfalz bestätigten mit Wirkungsgraden von bis zu 70 % die Wirksamkeit dieser Methode bei ausreichend großen Flächen und niedrigem Befallsniveau. Für den kleinparzellierten Anbau und bei höherem Befallsdruck wurden entomopathogene Nematoden im Freiland gegen überwinternde Larven mit heterogenen Wirkungsgraden erprobt. Es gelang nicht Pflaumenwickler ganzjährig unter Laborbedingen zu züchten, jedoch wurden mit Tieren aus Freilandsammlungen bzw. deren Eiern nach der Überwinterung Versuche zur Infektion der neonaten Larven mit dem Apfelwicklergranulosevirus, Eiparasitierungsversuche mit Trichogramma cacoeciae, zu Applikationen mit NeemAzal-T/S und zum Einsatz von insektenpathogen Pilzen gegen überwinternde Larven durchgeführt. Bei weiterführenden Versuchen im Freiland wurden mit dem Apfelwicklergranulosevirus V15 sehr heterogene Ergebnisse erzielt. Der Einsatz von Trichogramma in Form von Trichokarten ergab Wirkungsgrade von bis zu 47 %. Eine bessere Verteilung der Trichogramma in der Anlage sollte mit einer spritzfähigen Formulierung erreicht werden, dafür liegen jedoch erst einjährige Ergebnisse vor. Für die Bekämpfung der überwinternden Pflaumenwickler mit insektenpathogenen Pilzen stellte sich Isaria fumosorosea, als am geeignetsten heraus. Jedoch gestaltete sich bisher ein Nachweis der Wirksamkeit des mit dem Pilz infizierten Mulches im Freiland sehr schwierig. Die Pflaumenwicklerlarve sucht sich zur Überwinterung kleinste Ritzen am Stamm aus. Mit Wellpappe, die um den Stamm gewickelt wurde, konnte den Larven ein attraktives Überwinterungsquartier angeboten werden. Durch Entfernen und Verbrennen der Pappringe im Winter kann der Befallsdruck im Folgejahr minimiert werden. Für die Monilia-Regulierung an Zwetschgen konnte im Labor unter einer Vielzahl an getesteten Präparaten lediglich Serenade mit einer antagonistischen Wirkung überzeugen. Es hat jedoch keine Zulassung als Pflanzenschutzmittel im Steinobst. Versuche im Freiland ergaben außerdem, dass das konsequente Eliminieren von möglichen Infektionsquellen durch das Entfernen von Monilia-Nestern vor der Ernte und von Fruchtmumien nach der Ernte letztlich bessere Effekte erzielte, als Behandlungen mit mittelgut wirksamen Pflanzenstärkungsmitteln. Für die Behandlung der Monilia-Spitzendürre an Sauerkirschen wurden verschiedene Präparate im Freiland überprüft. Die Handelsprodukte BoniProtect® forte und BoniProtect® reduzierten tendenziell die Blüteninfektionen. Da für SPU 2720 und Cuprozin bisher nur aus einem Jahr Versuchsergebnisse vorliegen, ist keine abschließende Beurteilung möglich. Jedoch lässt sich bereits durch den konsequenten Rückschnitt befallener Triebe der Befallsdruck erheblich reduzieren. An beiden Standorten erscheinen die Sauerkirschsorten ‘Morina‘, ‘Jade‘, ‘Coralin‘ und ‘Safir‘ als geeignet für den ökologischen Anbau, in Weinsberg zusätzlich ‘Topas‘ und ‘Ungarische Traubige‘. Allerdings war der Monilia-Druck nur in wenigen Jahren hoch. Bis jetzt wurden keine Infektionen mit Gloeosporium sp., einer weiteren bedrohlichen Krankheit im ökologischen Sauerkirschanbau, beobachtet

Evaluation des Bundesprogramms "Soziale Teilhabe am Arbeitsmarkt" (Zb1-04812-2/31): zweiter Zwischenbericht

Das Bundesprogramm "Soziale Teilhabe am Arbeitsmarkt" zielt auf die Verbesserung der sozialen Teilhabe von arbeitsmarktfernen Langzeitleistungsbeziehenden im SGB II, die entweder mit Kindern in einer Bedarfsgemeinschaft leben und/oder auf Grund von gesundheitlichen Einschränkungen besonderer Förderung bedürfen. Es ist im Jahr 2015 gestartet und läuft bis zum 31.12.2018. An dem Programm nahmen zur Jahresmitte 2017 ca. 15.000 Personen in 195 Jobcentern teil. Das Bundesprogramm „Soziale Teilhabe am Arbeitsmarkt“ wird somit in knapp der Hälfte aller Jobcenter bundesweit umgesetzt. Der vorliegende Zwischenbericht stellt Zwischenergebnisse der programmbegleitenden Evaluation vor. Erstmals werden Ergebnisse aus Fallstudien zur lokalen Umsetzung vorgestellt, und es werden erstmals Ergebnisse aus der CATI-Befragung von Teilnehmenden und Kontrollpersonen zur sozialen Teilhabe, der zentralen Ergebnisvariable des Programms, vorgestellt.The programme "Social Inclusion in the Labour Market" (Soziale Teilhabe am Arbeitsmarkt) is a Federal labour market programme aiming to support social inclusion of persons with severe placement obstacles who are long-time receivers of Arbeitslosengeld II (minimum income support). The programme runs from 2015 to 31.12.2018 and focusses on persons who live together with children and / or who need special support due to health limitations. In 2017, about 15,000 persons from 195 Jobcenters participated, i.e. nearly a half of all Jobcenters in Germany have implemented the programme. This intermediate research report presents for the first time results from local case studies about the programme implementation. Furthermore, for the first time results concerning the social inclusion the main outcome variable of the programme of participants and non-participants are presented and discussed

Genetic background modulates phenotypes of serotonin transporter Ala56 knock-in mice

BACKGROUND: Previously, we identified multiple, rare serotonin (5-HT) transporter (SERT) variants in children with autism spectrum disorder (ASD). Although in our study the SERT Ala56 variant was over-transmitted to ASD probands, it was also seen in some unaffected individuals, suggesting that associated ASD risk is influenced by the epistatic effects of other genetic variation. Subsequently, we established that mice expressing the SERT Ala56 variant on a 129S6/S4 genetic background display multiple biochemical, physiological and behavioral changes, including hyperserotonemia, altered 5-HT receptor sensitivity, and altered social, communication, and repetitive behavior. Here we explore the effects of genetic background on SERT Ala56 knock-in phenotypes. METHODS: To explore the effects of genetic background, we backcrossed SERT Ala56 mice on the 129 background into a C57BL/6 (B6) background to achieve congenic B6 SERT Ala56 mice, and assessed autism-relevant behavior, including sociability, ultrasonic vocalizations, and repetitive behavior in the home cage, as well as serotonergic phenotypes, including whole blood serotonin levels and serotonin receptor sensitivity. RESULTS: One consistent phenotype between the two strains was performance in the tube test for dominance, where mutant mice displayed a greater tendency to withdraw from a social encounter in a narrow tube as compared to wildtype littermate controls. On the B6 background, mutant pup ultrasonic vocalizations were significantly increased, in contrast to decreased vocalizations seen previously on the 129 background. Several phenotypes seen on the 129 background were reduced or absent when the mutation was placed on the B6 background, including hyperserotonemia, 5-HT receptor hypersensivity, and repetitive behavior. CONCLUSIONS: Our findings provide a cogent example of how epistatic interactions can modulate the impact of functional genetic variation and suggest that some aspects of social behavior may be especially sensitive to changes in SERT function. Finally, these results provide a platform for the identification of genes that may modulate the risk of ASD in humans

Association of Systemic Medication Use with Glaucoma and Intraocular Pressure:The European Eye Epidemiology Consortium

Purpose: To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population. Design: Meta-analysis of 11 population-based cohort studies of the European Eye Epidemiology Consortium. Participants: The glaucoma analyses included 143 240 participants and the IOP analyses included 47 177 participants. Methods: We examined associations of 4 categories of systemic medications—antihypertensive medications (β-blockers, diuretics, calcium channel blockers [CCBs], α-agonists, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers), lipid-lowering medications, antidepressants, and antidiabetic medications—with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Results of multivariable regression analyses of each study were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in participants with diabetes only. Main Outcome Measures: Glaucoma prevalence and IOP. Results: In the meta-analyses of our maximally adjusted multivariable models, use of CCBs was associated with a higher prevalence of glaucoma (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.08 to 1.39). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR, 1.96; 95% CI, 1.23 to 3.12). No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with glaucoma. Use of systemic β-blockers was associated with a lower IOP (β coefficient, −0.33 mmHg; 95% CI, −0.57 to −0.08 mmHg). Monotherapy of both selective systemic β-blockers (β coefficient, −0.45 mmHg; 95% CI −0.74 to −0.16 mmHg) and nonselective systemic β-blockers (β coefficient, −0.54 mmHg; 95% CI, −0.94 to −0.15 mmHg) was associated with lower IOP. A suggestive association was found between use of high-ceiling diuretics and lower IOP (β coefficient, −0.30 mmHg; 95% CI, −0.47 to −0.14 mmHg) but not when used as monotherapy. No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with IOP. Conclusions: We identified a potentially harmful association between use of CCBs and glaucoma prevalence. Additionally, we observed and quantified the association of lower IOP with systemic β-blocker use. Both findings potentially are important, given that patients with glaucoma frequently use systemic antihypertensive medications. Determining causality of the CCB association should be a research priority. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p

Evaluation des Bundesprogramms "Soziale Teilhabe am Arbeitsmarkt": Erster Zwischenbericht

Das Bundesprogramm "Soziale Teilhabe am Arbeitsmarkt" zielt auf die Verbesserung der sozialen Teilhabe von arbeitsmarktfernen Langzeitleistungsbeziehenden im SGB II, die entweder mit Kindern in einer Bedarfsgemeinschaft leben und/oder auf Grund von gesundheitlichen Einschränkungen besonderer Förderung bedürfen. Es ist im Jahr 2015 gestartet und läuft bis zum 31.12.2018. Bislang nahmen knapp 10.000 Personen aus 105 Jobcentern an dem Programm teil. Eine Ausweitung des Programms hat zum Jahreswechsel 2016/17 stattgefunden. Der vorliegende Zwischenbericht stellt erste Ergebnisse der programmbegleitenden Evaluation vor.The programme "Social Inclusion in the Labour Market" (Soziale Teilhabe am Arbeitsmarkt) is a Federal labour market programme aiming to support social inclusion of persons with severe placement obstacles who are long-time receivers of Arbeitslosengeld II (minimum income support). The programme runs from 2015 to 31.12.2018 and focusses on persons who live together with children and/or who need special support due to health limitations. Until now, almost 10,000 persons from 105 Jobcenters participate in this programme. The programme will be extended from January 2017 on. This intermediate report presents first findings from the evaluation research team

Association of systemic medication use with glaucoma and intraocular pressure: the E3 Consortium

PURPOSE: To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population. DESIGN: Meta-analysis of eleven population-based cohort studies of the European Eye Epidemiology (E3) consortium. PARTICIPANTS: A total of 143240 participants were included in the glaucoma analyses and 47177 participants in the IOP analyses. METHODS: We examined associations of four categories of systemic medications (antihypertensive medications: beta-blockers, diuretics, calcium channel blockers [CCBs], alpha-agonists, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers; lipid-lowering medications; antidepressants; antidiabetic medications) with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Multivariable regression analyses were carried out in each study and results were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in diabetic participants only. MAIN OUTCOME MEASURES: Glaucoma prevalence and IOP. RESULTS: In the meta-analyses of our maximally-adjusted multivariable models, use of CCBs was associated with a higher prevalence of glaucoma (odds ratio [OR] with corresponding 95% confidence interval [95% CI]: 1.23 [1.08 to 1.39]). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR [95% CI]: 1.96 [1.23 to 3.12]). The use of other antihypertensive medications, lipid-lowering medications, antidepressants or antidiabetic medications were not clearly associated with glaucoma. Use of systemic beta-blockers was associated with a lower IOP (Beta [95% CI]: -0.33 [-0.57 to -0.08] mmHg). Monotherapy of both selective (Beta [95% CI]: -0.45 [-0.74 to -0.16] mmHg) and non-selective (Beta [95% CI]: -0.54 [-0.94 to -0.15] mmHg) systemic beta-blockers was associated with lower IOP. There was a suggestive association between use of high-ceiling diuretics and lower IOP (Beta [95% CI]: -0.30 [-0.47; -0.14] mmHg), but not when used as monotherapy. Use of other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were not associated with IOP. CONCLUSIONS: We identified a potentially harmful association between use of CCBs and glaucoma prevalence. Additionally, we observed and quantified the association of lower IOP with systemic beta-blocker use. Both findings are potentially important given that glaucoma patients frequently use systemic antihypertensive medications. Determining whether the CCB association is causal should be a research priority