Determination of albuminuria in the urine of diabetics for prevention and control of diabetic nephropathy

The issue: Diabetes has become the main cause of endstage renal disease. The costs for the treatment of diabetic patients with endstage renal disease have increased in the last years and have become a relevant economic topic of the health service. The first unspecific predictor of a diabetic nephropathy is an albuminuria. The screening for diabetic nephropathy uses microalbuminuria as a proof. Objectives: * What significance does the determination of albuminuria have on the precaution and course-control of the diabetic nephropathy? a) in type 1 diabetic patients, b) in type 2 diabetic patients * Which is an appropriate time to determine the albuminuria for the purpose of precaution and course-control of the diabetic nephropathy? a) in type 1 diabetic patients, b) in type 2 diabetic patients * Which method of testing is most effective concerning economic and medical aspects? Methods: Published literature from 1998 up to 2004 was identified by searching in the most important databases. Most of the guidelines were found by hand searching in the internet. Results: Of 2,792 citation titles and abstracts examined, 274 articles were retrieved for full-text review. Five metaanalyses and reviews, one review about clearing of guidelines (regarding 18 international guidelines) and four guidelines met the inclusion criteria for screening for microalbuminuria and type 1 diabetes. Seven metaanalyses, one HTA report, one review about clearing of guidelines (regarding 17 international guidelines), and seven guidelines met the inclusion criteria for screening for microalbuminuria and type 2 diabetes.At the moment, the determination of albuminuria still has a great significance because it is recommended in most published literature and guidelines. The time to determine the albuminuria depends on the age of the patients and their type of diabetes. Type 2 diabetic patients should start the determination when the diabetes is diagnosed whereas the determination is recommended five years later when type 1 diabetic patients are concerned. Most guidelines recommend a screening for microalbuminuria every year. Discussion and conclusion: All guidelines and most of the literature recommend this screening. However, these recommendations are only based on expert consensus. The specificity of this screening is rather low. False positive tests in type 2 diabetic patients will cause psychological problems. A positive test leads to the recommendation to achieve "normal blood pressure" and "normoglycaemia" - but this applies to each diabetic patient. Based on these facts, the screening for albuminuria in type 1 or type 2 diabetes patients cannot be recommended as long as benefit has not been demonstrated by large, clinical, controlled trials. Without an evidence of the benefit, this screening cannot be economic

Leading Evangelical Seminaries in German-Speaking Europe: A Transcendental Phenomenology

This transcendental phenomenology describes the essential experiences of lead administrators of evangelical seminaries in German-speaking Europe. Changes on a global scale in the educational sector are influencing the seminaries, and lead to processes of organizational academization and leadership professionalization. These developments have a profound influence on the role of the leadership of these seminaries. Each of the six lead administrators was interviewed three times to gather in-depth, thick, and rich descriptions of their lived experience with the phenomenon. For triangulation, observations, analyses of documents, and audio and visual data, as well as research memos and journals were included. The theoretical frameworks of spiritual leadership, servant leadership, and workplace spirituality guided the investigative process. Four textures emerged that describe what the lead administrators experience in their role: (a) leading spiritually; (b) leading collaboratively; (c) leading professionally; and (d) leading academically. Furthermore, four structures describe how the participants experience the phenomenon of seminary leadership: (a) experiencing leadership as a responsibility; (b) experiencing the negative dimensions of leadership; (c) experiencing the positive dimensions of leadership; and (d) experiencing leadership as a spiritual calling. Finally, three essential experiences and three essential influences of the phenomenon could be synthesized from the textural and structural descriptions. The essential experiences include the experience of spirituality, significance and meaning, and relationship. The essential influences include professionalization, academization, and diversification. The findings corroborate the literature in several points, but also added to existing knowledge of the phenomenon of leading evangelical seminaries in German-speaking Europe

COVID-19 and 5G conspiracy theories: long term observation of a digital wildfire

The COVID-19 pandemic has severely affected the lives of people worldwide, and consequently, it has dominated world news since March 2020. Thus, it is no surprise that it has also been the topic of a massive amount of misinformation, which was most likely amplified by the fact that many details about the virus were not known at the start of the pandemic. While a large amount of this misinformation was harmless, some narratives spread quickly and had a dramatic real-world effect. Such events are called digital wildfires. In this paper we study a specific digital wildfire: the idea that the COVID-19 outbreak is somehow connected to the introduction of 5G wireless technology, which caused real-world harm in April 2020 and beyond. By analyzing early social media contents we investigate the origin of this digital wildfire and the developments that lead to its wide spread. We show how the initial idea was derived from existing opposition to wireless networks, how videos rather than tweets played a crucial role in its propagation, and how commercial interests can partially explain the wide distribution of this particular piece of misinformation. We then illustrate how the initial events in the UK were echoed several months later in different countries around the world.publishedVersio

Don't Trust Your Eyes: Image Manipulation in the Age of DeepFakes

We review the phenomenon of deepfakes, a novel technology enabling inexpensive manipulation of video material through the use of artificial intelligence, in the context of today’s wider discussion on fake news. We discuss the foundation as well as recent developments of the technology, as well as the differences from earlier manipulation techniques and investigate technical countermeasures. While the threat of deepfake videos with substantial political impact has been widely discussed in recent years, so far, the political impact of the technology has been limited. We investigate reasons for this and extrapolate the types of deepfake videos we are likely to see in the future.publishedVersio

The Parental Concerns Questionnaire: A Brief Screening Instrument for Potentially Severe Behavior Problems in Infants and Toddlers At-Risk for Developmental Delays

The Parental Concerns Questionnaire (PCQ) was designed as a parent-interview screening instrument for young children with developmental concerns at risk for potentially severe behavior problems (SBDs). Parents of 262 young children (4 to 48 months) answered to the 15 dichotomous PCQ items interviewed by trained staff. Cluster analysis for items revealed three item clusters, which we labeled Developmental/Social (8 items), Biomedical (3 items), and Behavior Problems (3 items). This paper discussed primarily the Behavior Problems cluster, with items referring to self-injurious, aggressive, and destructive behaviors. Parents' concerns about behavior problems were high, with item-endorsements of the Behavior Problems cluster ranging from 41.8 % to 68.8 %. The Behavior Problems cluster was significantly correlated with all three subscales of the Behavior Problems Inventory (BPI-01), with select subscales of the Aberrant Behavior Checklist (ABC), and with the Repetitive Behavior Scale-Revised (RBS-R) providing some evidence for concurrent validity. Sensitivity and specificity data were computed for the three PCQ items as well as for the cluster score in comparison with the BPI-01, ABC, and RBS-R showing strong sensitivity. The PCQ Behavior Problems cluster is a useful screening checklist with high sensitivity for potential SBDs in young children at-risk for developmental delays