Global monitoring of average volume of alcohol consumption

Summary: Objectives: To estimate the prevalence of different categories of average volume of alcohol consumption for World Health Organization (WHO) regions. To check how the monitored indicator of average volume relates to prevalence of alcohol dependence. To discuss conclusions for establishing a global monitoring system. Methods: Prevalence of different categories of average volume of alcohol consumption was estimated by a triangulation of survey results, production, and sales figures. The relation between average volume of consumption and prevalence of alcohol dependence was analysed by regression techniques. Results: Alcohol consumption varies widely by sex, age, and region. It can predict prevalence of dependence with about 74% of the variation of the latter explained. Conclusions: With current data, global monitoring of alcohol is possible. However, more and better surveys are necessary for the future. They should include, patterns of drinking to improve prediction of other health outcomes like coronary heart disease (CHD) and accident

Continuity, psychosocial correlates, and outcome of problematic substance use from adolescence to young adulthood in a community sample

ABSTRACT: BACKGROUND: The study of the continuity, psychosocial correlates, and prediction of problematic substance use (PSU) across time from adolescence to young adulthood. METHODS: Substance use was studied in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS). Based on the frequency of tobacco, alcohol, and cannabis consumption, groups with PSU were defined at each of the three measurement points in time and compared to the rest of the sample. Comparisons included questionnaire data regarding emotional and behavioural problems, life events, coping style, self-related cognitions, perceived parenting style, perceived school environment, and size and efficiency of the social network. RESULTS: The size of the groups with PSU increased continuously across time. The cross-sectional correlates of PSU were characterized by a similar pattern that included higher scores for externalizing behaviour, and both number and negative impact of life events across all three times. At time 1 and 2 subjects with PSU also experienced less favourable parenting styles and school environments. Longitudinally, PSU in young adulthood was predicted most strongly and persistently by previous risk status, externalizing problems and male gender. CONCLUSION: Problematic substance use is a major problem in youth. Its contributing pattern of associated and predictive psychosocial variables can be identified in the community

[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning

<p>Abstract</p> <p>Purpose</p> <p>The observation that human meningioma cells strongly express somatostatin receptor (SSTR 2) was the rationale to analyze retrospectively in how far DOTATOC PET/CT is helpful to improve target volume delineation for intensity modulated radiotherapy (IMRT).</p> <p>Patients and Methods</p> <p>In 26 consecutive patients with preferentially skull base meningioma, diagnostic magnetic resonance imaging (MRI) and planning-computed tomography (CT) was complemented with data from [⁶⁸Ga]-DOTA-D Phe¹-Tyr³-Octreotide (DOTATOC)-PET/CT. Image fusion of PET/CT, diagnostic computed tomography, MRI and radiotherapy planning CT as well as target volume delineation was performed with OTP-Masterplan^®. Initial gross tumor volume (GTV) definition was based on MRI data only and was secondarily complemented with DOTATOC-PET information. Irradiation was performed as EUD based IMRT, using the Hyperion Software package.</p> <p>Results</p> <p>The integration of the DOTATOC data led to additional information concerning tumor extension in 17 of 26 patients (65%). There were major changes of the clinical target volume (CTV) which modify the PTV in 14 patients, minor changes were realized in 3 patients. Overall the GTV-MRI/CT was larger than the GTV-PET in 10 patients (38%), smaller in 13 patients (50%) and almost the same in 3 patients (12%). Most of the adaptations were performed in close vicinity to bony skull base structures or after complex surgery. Median GTV based on MRI was 18.1 cc, based on PET 25.3 cc and subsequently the CTV was 37.4 cc. Radiation planning and treatment of the DOTATOC-adapted volumes was feasible.</p> <p>Conclusion</p> <p>DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery.</p

Efficacy and Toxicity of Different Chemotherapy Protocols for Concurrent Chemoradiation in Non-Small Cell Lung Cancer—A Secondary Analysis of the PET Plan Trial

(1) Background: The optimal chemotherapy (CHT) regimen for concurrent chemoradiation (cCRT) is not well defined. In this secondary analysis of the international randomized PET-Plan trial, we evaluate the efficacy of different CHT. (2) Methods: Patients with inoperable NSCLC were randomized at a 1:1 ratio regarding the target volume definition and received isotoxically dose-escalated cCRT using cisplatin 80 mg/m2 (day 1, 22) and vinorelbin 15 mg/m2 (day 1, 8, 22, 29) (P1) or cisplatin 20 mg/m2 (day 1–5, 29–33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P2) or carboplatin AUC1 (day 1–5, 29–33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P3) or other CHT at the treating physician’s discretion. (3) Results: Between 05/2009 and 11/2016, 205 patients were randomized and 172 included in the per-protocol analysis. Patients treated in P1 or P2 had a better overall survival (OS) compared to P3 (p = 0.015, p = 0.01, respectively). Patients treated with carboplatin had a worse OS compared to cisplatin (HR 1.78, p = 0.03), but the difference did not remain significant after adjusting for age, ECOG, cardiac function creatinine and completeness of CHT. (4) Conclusions: Carboplatin doublets show no significant difference compared to cisplatin, after adjusting for possibly relevant factors, probably due to existing selection bias

Frequency, course and correlates of alcohol use from adolescence to young adulthood in a Swiss community survey

BACKGROUND: Few studies have analyzed the frequency of alcohol use across time from adolescence to young adulthood and its outcome in young adulthood. A Swiss longitudinal multilevel assessment project using various measures of psychopathology and psychosocial variables allowed for the study of the frequency and correlates of alcohol use so that this developmental trajectory may be better understood. METHOD: Alcohol use was studied by a questionnaire in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS). Other assessment included questionnaire data measuring emotional and behavioural problems, life events, coping style, self-related cognitions, perceived parenting style and school environment, and size and efficiency of the social network. RESULTS: The increase of alcohol use from early adolescence to young adulthood showed only a few sex-specific differences in terms of the amount of alcohol consumption and the motives to drink. In late adolescence and young adulthood, males had a higher amount of alcohol consumption and were more frequently looking for drunkenness and feeling high. Males also experienced more negative consequences of alcohol use. A subgroup of heavy or problem drinkers showed a large range of emotional and behavioural problems and further indicators of impaired psychosocial functioning both in late adolescence and young adulthood. CONCLUSION: This Swiss community survey documents that alcohol use is problematic in a sizeable proportion of youth and goes hand in hand with a large number of psychosocial problems

Entwicklungspsychopathologische Faktoren und Verläufe bei Heranwachsenden

Im Rahmen der vorliegenden kumulativen Dissertation wurden entwicklungspsycho- pathologische Faktoren und Verläufe bei Heranwachsenden beleuchtet, um einen Beitrag zu einem besseren Verständnis der komplexen Entwicklung in der Adoleszenz zu leisten. In diesem Zusammenhang erfolgte im ersten, epidemiologischen Teilprojekt eine systematische Literaturübersicht zu den Prävalenzen psychischer Störungen bei Kindern, Jugendlichen und jungen Erwachsenen bis 25 Jahren auf der Basis epidemiologischer Studien des Zeitraums von 1987 bis 2004. Weiter wurden in den folgenden zwei empirischen Teilprojekten auf der Basis von einer für den Kanton Zürich repräsentativen Längsschnittstudie die Entwicklungsverläufe von internalisierenden Problemen und Selbstwert sowie von problematischem Substanzkonsum über drei Messzeitpunkte vom Jugendalter bis ins junge Erwachsenenalter (bis 25 Jahre) analysiert.Im Rahmen der Literaturübersicht zeigte sich, dass mindestens jede siebte heranwachsende Person von psychischen Störungen mit Beeinträchtigung der Funktionstüchtigkeit betroffen ist, mit unterschiedlichem Verlauf verschiedener psychischer Störungen für die beiden Geschlechter. Von subklinischen internalisierenden Problemen sind sogar rund 30 Prozent der Jugendlichen mit einem starken Zusammenhang zum Selbstwert tangiert, bei weiblichen Jugendlichen mit einem sehr starken Zusammenhang. Von problematischem Substanz- konsum ist bis zum jungen Erwachsenenalter fast die Hälfte aller jungen Erwachsenen betroffen, begleitet von externalisierenden Verhaltensproblemen und problemmeidendem Verhalten. Für die Behandlung und Prävention klinischer Störungen und subklinischer Probleme im Jugendalter sind altersspezifische Methoden wichtig. In der Kindheit und frühen Adoleszenz ist ein Fokus auf wahrgenommenes elterliches Erziehungsverhalten empfehlenswert, bei älteren Heranwachsenden sollten jedoch schulbezogene Faktoren und Peerbeziehungen stärker im Zentrum stehen. Bei weiblichen Jugendlichen wird bei der Behandlung und Prävention ein zusätzlicher Fokus auf internalisierende Probleme und einen tiefen Selbstwert empfohlen. Bei problematischem Substanzkonsum sollte hingegen unabhängig vom Geschlecht die Schwerpunktsetzung bei externalisierenden Verhaltensproblemen und problemmeidendem Verhalten liegen. Für das weitere vertiefte Verständnis von entwicklungspsychopathologischen Faktoren sind zusätzliche Studien von Interesse, speziell mit einem Fokus auf kompensatorische und protektive Faktoren. This dissertation intended to shed further light on developmental and psychopathological factors in order to contribute to a better understanding of the complexity of adolescence. First, a review based on epidemiological studies published between 1987 and 2004 analysed the prevalence of mental disorders in children, adolescents, and young adults up to the age of 25. Furthermore, two empirical projects based on a representative longitudinal sample from the canton of Zurich studied developmental trajectories of internalising problems and self-esteem as well as problematic substance use at three times from adolescence to young adulthood up to the age of 25. According to the review, at least one in seven young people was identified as suffering from mental-health problems including deficits in global psychosocial functioning. Different developmental characteristics of various mental disorders were apparent in the two genders. Sub-clinical internalising problems affect 30 per cent of adolescents and have a strong association with self-esteem, particularly in females. Problematic substance use was even more prevalent; nearly half of the young adults were affected. It was accompanied by externalising problem behaviour and avoidant coping. Treatment and prevention of clinical symptoms and sub-clinical problems should be based on age-specific approaches. In childhood and early adolescence, a focus on perceived parental behaviour is suggested, whereas in older adolescents school-related factors and peer relationships should become crucial. Furthermore, there should be an additional focus on internalising problems and low self-esteem in female adolescents. Independently of gender, interventions in problematic substance use require a focus on externalising behavioural problems and avoidant coping in adolescents and young adults. For a better understanding of developmental psychopathological factors, further studies should focus particularly on compensatory and protective factors

Die Prävalenz psychischer Störungen bei Kindern und Jugendlichen unter Berücksichtigung soziodemografischer Merkmale

Theoretischer Hintergrund: Die Bedeutung soziodemografischer Merkmale für die Prävalenz psychischer Störungen bei Kindern und Jugendlichen. Fragestellung und Methode: Es werden Zusammenhänge zwischen der Prävalenz psychischer Störungen bei Kindern und Jugendlichen und soziodemografischen Merkmalen auf der Basis epidemiologischer Studien des Zeitraumes 1987 bis 2004 analysiert. Ergebnisse: Die mittlere Periodenprävalenz beträgt ohne Berücksichtigung der Funktionstüchtigkeit 22 Prozent und mit Berücksichtigung der Funktionstüchtigkeit 16 Prozent. Bei Jungen wurden im Kindesalter und nur teilweise im Jugendalter höhere Prävalenzraten gefunden. Weibliche Jugendliche weisen insgesamt höhere Gesamtprävalenzraten auf als männliche Jugendliche. Im jungen Erwachsenenalter vollzieht sich eine Wiederangleichung der Prävalenzen. Tendenziell besteht in einigen Studien eine höhere Wahrscheinlichkeit für psychische Störungen in tiefen Sozialschichten. Schlussfolgerungen: Die Forschung sollte neben der Erforschung von Prävalenzen und Risikofaktoren den Fokus vermehrt auf einheitlichere Untersuchungsstandards richten. Background: Impact of socio-demographic characteristics on prevalence of mental disorders in children and adolescents. Objectives and methods: Based on epidemiological studies published between 1987 and 2004, this review analyzes associations between the prevalence of mental disorders in children and adolescents and socio-demographic characteristics. Results: The mean period prevalence without considering global psychosocial functioning amounts to 22%; this declines to 16 % when deficits in global psychosocial functioning are taken into account. Prevalence rates are higher in males than in females during childhood, and in some studies also in adolescence. Prevalence rates in female adolescents, are higher than in male adolescents. In young adulthood, prevalence rates tend to become more similar again. Some studies tend to show a higher probability of mental disorders in subjects of lower socioeconomic status. Conclusions: Besides the assessment of prevalence rates and their associations with risk factors, future research should focus more on more homogenous standards of assessment