A European research agenda for somatic symptom disorders, bodily distress disorders, and functional disorders: Results of an estimate-talk-estimate delphi expert study

Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe

Høje, landskab og bosættelse – Rekognosceringer ved Tobøl-Plougstrup-højgruppen

Barrows, Landscape and SettlementField surveys at the Tobøl-Plougstrup barrow groupA group of barrows located between the villages of Tobøl and Plougstrup in the parishes of Føvling and Jernved in Ribe County has on several occasions been the object of intense archaeological interest. The group consists of 26 burial mounds all situated close to or in some cases almost directly on the eroded banks of the Kongeå river meadows (fig. 1). Extraordinarily lavish grave goods together with conspicuously large mounds have contributed to an impression of an area of special significance in prehistory. It is, however, the recovery of well-preserved oak log coffins from the Early Bronze Age in three different mounds, which in particular has drawn attention to the locality. The coffins were in every case uncovered under adverse circumstances leaving only scattered information on find circumstances and grave goods. As part of a larger research program the Tobøl-Plougstrup area was revisited in 1999 where a number of drillings were carried out in selected mounds. The aim was to obtain knowledge on prehistoric soil development, principles of barrow construction and preservation of organic matter in the mounds. In the core of several mounds the presence of an iron pan encapsulation was detected. These iron pans facilitate the preservation of organic matter and have been observed in connection with almost all discoveries of oak log coffins. Recent investigations suggest that the iron pans have developed because of special constructionmethods. This has added to the impression of the special role of the barrow group. In the period 2002-2004 the five ­metre-high Skelhøj mound will be excavated. With an iron pan encapsulated core the excavation opens the possibility of improved insights into a variety of aspects of Early Bronze Age society. Furthermore, soil analyses of sod material from the other mounds throw light on long-term cultural exploitation of the areas in the vicinity of the individual mounds. Existing information on Late Neolithic and Early Bronze Age finds suggests that settlement was restricted to the southern side of the Kongeåen, opposite the mounds (fig. 1). This leaves an impression of a secluded ritual landscape on the northern banks of the river. Focusing on the overall role of mound building and its effect on the development of settlement and landscape it was decided to carry out a systematic field survey of the area. The applied survey strategy had to enable studies of both regular occupation sites and patterns of “off-site” land use. Based on this demand and a wish to preserve the compatibility of the collected material it was decided to apply a strategy of adaptive cluster sampling. Adaptive cluster sampling is a recently developed statistical sampling procedure intended for clustered populations. It is based upon an initial randomised or systematic distribution of sample units in a regular grid. If a predetermined critical value is exceeded in a unit, its neighbouring units are also sampled (fig. 2). The method in this way focuses on the relatively most informative clusters of the material without losing the statistical properties. This makes it well suited for archaeological field surveying.In practice, the sampling at Tobøl-Plougstrup started out with a systematic grid of 20x20 m squares in which every 9th square was initially subjected to a 20 min. single person survey. The total sample area covers five square kilometres (fig. 3). It was decided to collect all artefacts, estimated to be more than 200 years old. If a square exceeded a critical value of artefacts four of the adjacent squares were surveyed. The method proved very effective for sampling and delimiting, even in connection with small concentrations of cultural remains (fig. 4). Information on all collected material is contained in a digital database (fig. 5 gives a schematic description of the database in Danish). The survey is still preliminary and the results should be treated accordingly. However, some overall tendencies are observed. The distribution of four chronologically significant categories of ceramics reveals tempo-spatial patterning (fig. 6). Flint of good quality is very scarce in the area, which is reflected in several aspects of the flint assemblage, for instance the size and exploitation of the cores (fig 7). As regards the production of larger tools like thin-butted flint axes, only the last stages of reduction are present suggesting that these implements entered the area almost completed (fig. 8). The distribution of formal flint tools is to a large extent in accordance with the distribution of ceramics. Two early/ Neolithic/early middle Neolitihic concentrations on the southern side of the Kongeå stand out in particular (fig. 9). Bifacial tools from Late Neolithic and Early Bronze Age are found primarily at three different locations. In the central part of the barrow group, between two concentrations of barrows, some scattered finds of bifacial tools are present (fig. 10). This distribution of finds is compared to the evidence of prehistoric soil development as attested by the drillings in the mounds. Based on this comparison a zoning of the landscape exploitation is hypothesised (fig 11). In conclusion, as regards methodology, adaptive cluster sampling has been quite manageable in the field and must be recognised as a preferable alternative to conventional sampling and surveying. A survey of the remaining part of the Tobøl-Plougstrup area is to be carried out in the near future.Steffen Terp LaursenKasper Lambert JohansenMads Kähler HolstDepartment of Prehistoric Archaeology,University of AarhusMoesgårdMarianne RasmussenHistorical-Archaeological Research Centre, Lejre

Развитие креативности подростков средствами дисциплин гуманитарного цикла: автореф. дис. ... канд. пед. наук: 13.00.01

Future development of eHealth programs (automated web-based health interventions) will be furthered ifprogram design can be based on knowledge of eHealth’s working mechanisms. A promising and pragmaticmethod for exploring potential working mechanisms is qualitative interview studies, in which eHealthworking mechanisms can be explored through the perspective of the program user. Qualitative interviewstudies are promising because they are suited for exploring what is yet unknown, building new knowledgeand constructing theory. They are also pragmatic, because the development of eHealth programs oftenentails user interviews for applied purposes (e.g. getting feedback for program improvement or identifyingbarriers for implementation). By capitalizing on these existing (applied) user interviews to also pursue (basic)research questions of how such programs work, the knowledge base of eHealth’s working mechanisms cangrow quickly. To be useful, such interview studies need to be of sufficient quality, which entails that theinterviews should generate enough data of sufficient quality relevant to the research question (i.e. “richdata”). However, getting rich interview data on eHealth working mechanisms can be surprisingly challenging,as several of the authors have experienced. Moreover, when encountering difficulties as we did, there arefew places to turn to: there are currently no guidelines for conducting such interview studies in a way thatensure their quality. In this paper, we build on our experience as well as the qualitative literature to addressthis need, by describing five challenges that may arise in such interviews and presenting methodologicaltools to counteract each challenge. We hope the ideas we offer will spark methodological reflections andprovide some options for researchers interested in using qualitative interview studies to explore eHealth’sworking mechanisms