12 research outputs found

    Evaluation of two prevention programs `Early Steps' and `Faustlos' in daycare centers with children at risk: the study protocol of a cluster randomized controlled trial

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    Background: While early programs to prevent aggression and violence are widely used, only a few controlled trials of effectiveness of psychoanalytically based prevention programs for preschoolers have been evaluated. This study compares `Faustlos' (a violence prevention program) and `Early Steps' (a psychoanalytically based, whole daycare center intervention to prevent violence) in daycare centers in socioeconomically deprived neighborhoods. Methods/Design: Preschoolers in 14 daycare centers in Frankfurt, Germany, participate in a cluster randomized controlled trial (CRCT). The daycare centers were randomly chosen from a representative baseline survey of all Frankfurt's daycare centers carried out in 2003 (n = 5,300) with the following stratifying factors: children's aggressiveness, hyperactivity, anxiety and socioeconomic status. Additionally, the geographic identification of socioeconomically deprived neighborhoods regarding low-income children was taken from the Frankfurt Municipality Statistics. Children's attachment classification and children's aggressiveness, hyperactivity, anxiety and social competence are measured as outcome criteria before and after 2 years of intervention. The programs in the study aim to reach a high-risk population. Therefore, the combination of a random sampling of daycare centers out of a representative baseline survey in all daycare centers in Frankfurt and the application of official data on the local distribution of low-income children are unique features offered by the EVA study design. Data on preschooler's attachment representations are collected in socioeconomically deprived neighborhoods for the first time

    Evaluation of two prevention programs `Early Steps' and `Faustlos' in daycare centers with children at risk: the study protocol of a cluster randomized controlled trial

    Get PDF
    Background: While early programs to prevent aggression and violence are widely used, only a few controlled trials of effectiveness of psychoanalytically based prevention programs for preschoolers have been evaluated. This study compares `Faustlos' (a violence prevention program) and `Early Steps' (a psychoanalytically based, whole daycare center intervention to prevent violence) in daycare centers in socioeconomically deprived neighborhoods. Methods/Design: Preschoolers in 14 daycare centers in Frankfurt, Germany, participate in a cluster randomized controlled trial (CRCT). The daycare centers were randomly chosen from a representative baseline survey of all Frankfurt's daycare centers carried out in 2003 (n = 5,300) with the following stratifying factors: children's aggressiveness, hyperactivity, anxiety and socioeconomic status. Additionally, the geographic identification of socioeconomically deprived neighborhoods regarding low-income children was taken from the Frankfurt Municipality Statistics. Children's attachment classification and children's aggressiveness, hyperactivity, anxiety and social competence are measured as outcome criteria before and after 2 years of intervention. The programs in the study aim to reach a high-risk population. Therefore, the combination of a random sampling of daycare centers out of a representative baseline survey in all daycare centers in Frankfurt and the application of official data on the local distribution of low-income children are unique features offered by the EVA study design. Data on preschooler's attachment representations are collected in socioeconomically deprived neighborhoods for the first time

    Femoral antecurvation-A 3D CT Analysis of 1232 adult femurs.

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    INTRODUCTION:For optimal treatment of femoral fractures, it is essential to understand the anatomical antecurvation of the human femur. Recent clinical studies have highlighted the problem of distal anterior encroachment or even perforation of the nail tip. The aim of this study was to accurately describe the femoral antecurvation in a large cohort. Another objective was to identify the most important influences on femoral antecurvation, such as age, femur length, gender and ethnicity. METHODS:A three dimensional modelling and analytical technology was applied for the analysis of 1,232 femurs. Individual femoral antecurvation was precisely computed to determine whether gender, femur length, age, ethnicity or body mass index influence the radius of curvature (ROC). RESULTS:The calculated mean ROC for all femurs was 943 mm. The lowest ROC of 826 mm was found in female Asian femurs. A regression analysis demonstrated that age and femur length could predict the variability of the curvature, with femoral length as most powerful predictor. A matched pair subgroup analysis between Asians and Caucasians could not show any significant differences of ROC values. CONCLUSIONS:The mean radius of the femoral antecurvation may be smaller than previously reported revealing a significant mismatch between the actual individual anatomy and existing implants. In opposite to existing literature, this study suggests, that antecurvation differences between various ethnicities may exclusively be attributed to differences in femoral length and age. The findings of this study may be found helpful in the development of novel designs for intra- and extramedullary implants

    Differences in Outcomes Reported by Patients With Inflammatory Bowel Diseases vs Their Health Care Professionals

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    Somatic mosaicism and common genetic variation contribute to the risk of very-early-onset inflammatory bowel disease

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    Very-early-onset inflammatory bowel disease (VEO-IBD) is a heterogeneous phenotype associated with a spectrum of rare Mendelian disorders. Here, we perform whole-exome-sequencing and genome-wide genotyping in 145 patients (median age-at-diagnosis of 3.5 years), in whom no Mendelian disorders were clinically suspected. In five patients we detect a primary immunodeficiency or enteropathy, with clinical consequences (XIAP, CYBA, SH2D1A, PCSK1). We also present a case study of a VEO-IBD patient with a mosaic de novo, pathogenic allele in CYBB. The mutation is present in ~70% of phagocytes and sufficient to result in defective bacterial handling but not life-threatening infections. Finally, we show that VEO-IBD patients have, on average, higher IBD polygenic risk scores than population controls (99 patients and 18,780 controls; P < 4 × 10-10), and replicate this finding in an independent cohort of VEO-IBD cases and controls (117 patients and 2,603 controls; P < 5 × 10-10). This discovery indicates that a polygenic component operates in VEO-IBD pathogenesis
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