4 research outputs found
An Update Based on the SCORE-Deutschland Risk Charts
Estimation of absolute risk of cardiovascular disease (CVD), preferably with
population-specific risk charts, has become a cornerstone of CVD primary
prevention. Regular recalibration of risk charts may be necessary due to
decreasing CVD rates and CVD risk factor levels. The SCORE risk charts for
fatal CVD risk assessment were first calibrated for Germany with 1998 risk
factor level data and 1999 mortality statistics. We present an update of these
risk charts based on the SCORE methodology including estimates of relative
risks from SCORE, risk factor levels from the German Health Interview and
Examination Survey for Adults 2008–11 (DEGS1) and official mortality
statistics from 2012. Competing risks methods were applied and estimates were
independently validated. Updated risk charts were calculated based on
cholesterol, smoking, systolic blood pressure risk factor levels, sex and
5-year age-groups. The absolute 10-year risk estimates of fatal CVD were lower
according to the updated risk charts compared to the first calibration for
Germany. In a nationwide sample of 3062 adults aged 40–65 years free of major
CVD from DEGS1, the mean 10-year risk of fatal CVD estimated by the updated
charts was lower by 29% and the estimated proportion of high risk people
(10-year risk > = 5%) by 50% compared to the older risk charts. This
recalibration shows a need for regular updates of risk charts according to
changes in mortality and risk factor levels in order to sustain the
identification of people with a high CVD risk
DUDE - a universal prevention program for non-suicidal self-injurious behavior in adolescence based on effective emotion regulation: study protocol of a cluster-randomized controlled trial
Background
Non-suicidal self-injury (NSSI) has become a substantial public health problem. NSSI is a high-risk marker for the development and persistence of mental health problems, shows high rates of morbidity and mortality, and causes substantial health care costs. Thus, there is an urgent need for action to develop universal prevention programs for NSSI before adolescents begin to show this dangerous behavior. Currently, however, universal prevention programs are lacking.
Methods
The main objective of the present study is to evaluate a newly developed universal prevention program (“DUDE – Du und deine Emotionen / You and your emotions”), based on a skills-based approach in schools, in 3200 young adolescents (age 11–14 years). The effectiveness of DUDE will be investigated in a cluster-randomized controlled trial (RCT) in schools (N = 16). All groups will receive a minimal intervention called “Stress-free through the school day” as a mental health literacy program to prevent burnout in school. The treatment group (N = 1600; 8 schools) will additionally undergo the universal prevention program DUDE and will be divided into treatment group 1 (DUDE conducted by trained clinical psychologists; N = 800; 4 schools) and treatment group 2 (DUDE conducted by trained teachers; N = 800; 4 schools). The active control group (N = 1600; 8 schools) will only receive the mental health literacy prevention. Besides baseline assessment (T0), measurements will occur at the end of the treatment (T1) and at 6- (T2) and 12-month (T3) follow-up evaluations. The main outcome is the occurrence of NSSI within the last 6 months assessed by a short version of the Deliberate Self-Harm Inventory (DSHI-9) at the 1-year follow-up (primary endpoint; T3). Secondary outcomes are emotion regulation, suicidality, health-related quality of life, self-esteem, and comorbid psychopathology and willingness to change.
Discussion
DUDE is tailored to diminish the incidence of NSSI and to prevent its possible long-term consequences (e.g., suicidality) in adolescents. It is easy to access in the school environment. Furthermore, DUDE is a comprehensive approach to improve mental health via improved emotion regulation