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Regular breakfast skipping is related to unhealthy dietary behaviours, such as consuming an overall poorer quality diet, lower rates of physical activity, both of which are linked to a higher body mass index. Adolescent breakfast-skippers struggle with mental focus, sleep issues and lower grades. Solutions that can be implemented to overcome breakfast skipping are needed.
A systematic literature review was undertaken to identify programs that aimed to increase breakfast eating. Following the PRISMA framework studies were sourced to examine details of behaviour change, evidence of theory use and other important program learnings and outcomes.
Breakfast consumption empirical studies published from 2000 onwards.
Nineteen empirical studies that aimed to improve breakfast eating behaviour.
Out of the 19 studies examined, ten studies reported an increase in breakfast consumption frequency for the entire study group or subgroups. Seven studies found no change, one was inconclusive, and one observed a decrease in breakfast frequency. Positive changes to the dietary quality of breakfast were observed in five of the studies that did not observe increased frequency of breakfast consumption. Only six studies reported using theory in the intervention.
This evidence review points to the need to extend theory application to establish a reliable evidence base that can be followed by practitioners seeking to increase breakfast eating rates in their target population.
The Council Fathers at Vatican II struggled to negotiate the Council's teaching on divine revelation with regard to the teaching of Trent, but more immediately with regard to the modern theology of the Magisterium and the modern value of historical criticism that had recently been recognized by Pius XII as having a legitimate role in the interpretation of Scripture. Dei Verbum's teaching stressed the unity of Scripture and tradition in the revelation of God's word, but never considered the role of historical criticism in the interpretation of God's word in tradition that it affirmed in God's revelation in the biblical word. This article argues that the recognition of the legitimate role of historical criticism in the interpretation of tradition remains an issue of needed development in the teaching of Dei Verbum.
To enhance the success of innovations, various methods for foresight have been developed. Automatization yields the potential of shifting effort away from the process to the actual in-depth analysis of resulting scenarios in scenario-technique. Within this paper, an approach based on a user-specific classification of input factors (consistency values) is presented. Generic consistency patterns used for a semi-automatized consistency assessment based on artificial neural networks are identified using a case study approach. Hereby, the effort for scenario-technique can be reduced significantly.
As time-to-market is getting shorter, customer needs have to be identified as early as possible in product development. Correctly applied, corporate foresight can give a glimpse into the future to anticipate such needs and thus gain a competitive advantage. A support tool to choose the appropriate method of foresight is not available yet. Thus, a literature study on foresight methods in industry is performed and a novel decision support tool is proposed which avoids high entrepreneurial risks. Based on the findings, potentials for future work are identified for different types of methods.
With design methodologies, as Integrated Product Development, industry is continuously looking to improve their product development processes. Staying ahead concurrence forces them to deliver new and more complex products in shorter time. When it comes to fast delivery and requirement changes, product development can be inspired by agile methods. Although the application is difficult, the idea to implement these methods for development of products other than software comes out. To ease its implementation, this paper proposes to use IPD as a framework for agile product development.
Since the combination of thermodilution with the balloon-tipped pulmonary arterial catheter by Swan and Ganz in the 1970s, researchers and clinicians have pursued the measurement and optimization of cardiac output to improve outcomes both in the operating room and the intensive care unit. Complications related to the invasiveness of this device have driven exploration of new methods to acquire the same information without the deleterious side effects, with mixed results. We will discuss several of these devices, the physical principles underlying their measurements, their relative accuracy compared to clinical and experimental standards, and clinical advantages and disadvantages of each device.
Pain is a psychosomatic occurrence, primarily considering its neurobiological aspects. Chronic pain patients suffer from psychic comorbidities or even psychic diseases as somatoform disorders which often remain mis- and respectively underdiagnosed and consecutive untreated. Psychic comorbidities influence the pain in a neurobiological sense by lowering the pain threshold. Wrong treatments, somatic fixation, operations, chronification, iatrogenic impairment and psychosocial problems are possible consequences. It is fundamental to integrate the trias of pain, stress and affect into the diagnostics and treatments. The neurobiological stress axis, HPA- and LC-NE, is known to be activated by nociceptive- neuropathic input via cytokinins and influence pain. Chronic negative strain of the stress system may have neurobiological consequences as damage of the pain depressant systems, inter alia degeneration of hippocampus.
An interdisciplinary approach is inevitable and broad clinical diagnostics of high importance. Therefore we established a broad network of interdisciplinary liaisons with rheumatology, internal medicine, orthopaedics and dentistry. In our outpatient clinic we analyzed female and male chronic pain patients from different medical departments. They all had a complex and long lasting history of pain.
We applied clinical interviews and different test-parametric methods and figured out that undiscovered psychic comorbidities, wrong medication and specific biographic aspects in a biopsychosocial kind are inter alia the key factors of chronic pain suffering.
Our data demonstrate that an interdisciplinary approach considering pain as multifactor genesis and integrating neurobiological, biographic and psychosocial components is necessary to treat chronic pain patients and prevent further chronification.
Body Integrity Identity Disorder (BIID) describes a pathology which is associated with an overwhelming wish of amputation of one or more healthy body parts. Originally the disease was indicated as “Apotemnophilia”, afterwards as “Amputee-Identity-Disorder”. Patients feel an incompleteness of their body identity. Only the amputation is perceived as solution for the conflict. The wish of amputation often exists since their childhood or adolescence. The persistent wish for amputation is very incriminating for the patients, embarrassing and can have devastating consequences like self-amputation. Little is known about the aetiology and pathogenesis. In the very few described single-cases neither psychotherapy nor psychotropics were efficient.
To gain new insights into the aetiology and neural mechanisms of the BIID pathology, we arranged a complex psychometric examination, clinical interviews and functional magnetic resonance imaging (fMRI) measurements with male BIID patients and healthy subjects as control group. In the fMRI- Scanner patients looked to manipulated pictures of themselves, in which they are shown in the actual, real state and the desired state with one/both arms or legs amputated and with prosthesis. The psychometric examination contained different screening instruments for depression, personality, patterns of relationship, attachment etc.
Results of our first patient showed that he had superior intelligence, good social abilities, a challenging employment and a longtime relationship. He was inconspicuous in all psychometric measurements.
The neuroimaging findings of all patients are evaluated and interpreted in the context of biography and personality features. Our study furnishes new insights into characteristics, brain activity and possible therapeutic implications.
The purpose of this study was to demonstrate the usefulness of multi-group piece-wise latent growth curve models (LGCM) in clinical research, particularly for assessing and comparing treatment effects. As an empirical example, this analytic technique was used to compare the effectiveness of Guided Self-Change (GSC) and Cognitive Behavioral Therapy (CBT) treatments for bulimia nervosa.
Sixty-two female patients (M age = 28.1, SD = 8.00) with bulimia nervosa were randomly assigned to a) a GSC treatment involving a self-care manual plus 8 bi-weekly sessions of CBT or b) 16 weekly sessions of CBT.
Both groups showed significant improvements in treatment outcomes across the treatment period, although the CBT group showed greater improvements. However, the GSC group evidenced more continued improvement post-treatment. CBT showed greater variability in effectiveness during the treatment period, while GSC showed greater variability during follow-up. For GSC patients, baseline levels on some treatment outcomes were related to follow-up improvement levels.
LGCM provided a rich analysis of these data, and addressed important questions regarding differences in the effectiveness of the two treatment programs. For example, CBT tended to show greater improvements during treatment, while GSC evidenced more continued improvements during follow-up.
Patients with obsessive-compulsive disorder (OCD) with the compulsion to wash have fear of contamination or feel contaminated. The compulsion to wash often lasts for hours, so that massive difficulties to cope with everyday life follow. There exist only few data on the aetiology of specific OCD-subgroups as the compulsive disorder to wash. Specific neural correlates of OCD with compulsion to wash have never been analyzed before. Existing neuroimaging data on OCD generally show changes of neural activity in the striatum, orbitofrontal cortex and anterior cingulated gyrus. A dysfunction of frontostriatal loops is supposed as one cause of OCD. From a psychoanalytic point of view OCD with the specific compulsion to wash is related to a suppression of autosexual and aggressive drives.
In our neuroimaging study (fMRI) we compared the neural networks of OCD-patients with the compulsion to wash and healthy controls. We used a picture-paradigm consisting of autosexual, aggressive, disgusting, neutral and water pictures. We were interested in the neural correlates of OCD-patients with compulsion to wash regarding the different affective pictures categories and expected neural differences between patients and controls. Stimuli were taken partly from the IAPS, partly also self- constructed and validated by a control group. First results point at significant differences in neural activity between patients and healthy controls, especially in diseases-related components as autosexual, aggressive and water pictures. OCD-patients used a more extended and more emotional related network of brain structures.
Our study provides new insights into neural correlates of OCD-patients with the compulsion to wash.
The postpartum depression occurs between the 2nd and 6th week after birth. It is characterized by ambivalent emotions concerning the baby, excessive demands, feelings of guilt, fears of failure, panic attacks and sometimes culminates in suicide or infanticide. Previous studies show prevalence between 5 and 15%. In Germany only few data exist concerning epidemiology, aetiology and risk factors. Previous psychological diseases, especially depression, missing social support and bad partner support are important components. There is nothing common about the neural correlates of postpartum depression so far. Patients, midwives and gynaecologists rarely have information about experts and possibilities of treatment. Because the postpartum depression has devastating consequences for the mother and for the development of the child, a close cooperation between gynaecological, midwives and psychosomatic disciplines is essential and a directed psychotherapeutic consultation absolutely necessary.
Therefore we accomplish an interdisciplinary project with a multimodal approach. Besides a ‘postpartum-depression-hotline’, which is well-staffed by experts 24 hours, a new homepage concerning postpartum depression is available (www.wochenbettdepression-hotline.de). Therapeutic support for mothers and fathers occurs immediately by our team and a mother-child-unit is available. Turkish patients are included to assess intercultural influences. Clinical interviews and psychometric instruments are used to analyze personality, attachment, body perception etc. For the first time neural networks of postpartum depression are examined by fMRI. A picture-paradigm is used.
By our interdisciplinary approach we already established a broad supportive network in only few months.
Our psychometric and fMRI results contribute to further knowledge of aetiology and risk factors of postnatal depression.
Primary insomnia (PI) is a highly prevalent health problem worldwide and has been identified as a risk factor for major somatic and mental disorders. Still, less than 50% of all individuals with chronic PI show full remission with optimized first line treatment, indicating the need for additional research. The broad objective of this study was to test acceptance and commitment therapy (ACT) as a supplement to first line treatment in order to improve non-pharmacological interventions for insomnia.
Specific aims were i) to evaluate whether ACT is feasible in patients with PI and ii) to collect preliminary efficacy data. Improvements of subjective sleep quality and quality of life (QoL) were hypothesized.
Eleven individuals with chronic PI without comorbidities who were non- or partial responders to Cognitive Behavior Therapy were included. They participated in six weekly ACT sessions in an outpatient group setting. Primary outcomes were subjective sleep quality as measured by sleep diary data, and quality of life as measured by the World Health Organization Quality of Life. Data were collected at two baselines, post-treatment and at three-months-follow-up.
Ten individuals completed the study. Sleep parameters did not significantly change across the study. Importantly, the QoL across different domains was significantly improved after ACT. Sleep-related avoidance behavior was significantly reduced. Effect sizes for QoL and avoidance behavior changes were large.
The data provide preliminary evidence that ACT as a group program is feasible in individuals with chronic PI and could be a helpful supplement to existing treatments especially with the aim of improving QoL.
Interpersonal psychotherapy (IPT) is one of the few psychological methods whose efficacy has been demonstrated for affective disorders. The approach was originally designed specifically for the outpatient treatment of acute unipolar depressive episodes. Since the method has proven to be successful, it has been modified in many ways e.g. for the inpatient setting and treatments for numerous mental disorders.
IPT conceptualizes depression as a multifactorial psychiatric disorder that develops in an interpersonal context. The therapeutic work therefore focusses on the current circumstances of the person's life, which are related to depressive episode (e.g. partnership conflict, change of roles in the context of maternity or caring for a relative). The therapeutic work takes place in the here and now. The patient is helped to deal with interpersonal problems, to develop appropriate social skills to cope with its difficulties and to reduce depressive symptoms. The theoretical basis of the IPT is the interpersonal theory of Sullivan and Bowlby's attachment theory. Specific interpersonal techniques (e.g. communication analysis) as well as techniques of other therapy schools (e.g. actualization of emotions, clarification and roleplaying) are applied.
The aim of the workshop is to give an introduction to the IPT, in particular working with the four different foci conflicts, change of roles, pathologic grief and interpersonal deficits as well as the work with IPT in the individual and inpatient setting.
We prove that Cuntz semigroups of C*-algebras satisfy Edwards' condition with respect to every quasitrace. This condition is a key ingredient in the study of the realization problem of functions on the cone of quasitraces as ranks of positive elements. In the course of our investigation, we identify additional structure of the Cuntz semigroup of an arbitrary C*-algebra and of the cone of quasitraces.
In the global effort to strengthen national identification systems (SDG 16.9), biometric identification technologies and civil registration systems have been associated with different motives and applications, thus fuelling their competition for public attention and resources. The case of Ghana illustrates how these alternative systems, along with further sources of personal data, have recently been integrated into the larger political vision of a centralised, national population data system. Based on ethnographic fieldwork, the paper traces the difficulties and institutional negotiations that accompany this integration into a centralised population data infrastructure. Acknowledging how sets of actors, infrastructures and power relations are layered onto each other to unintended effects, the article describes the historical process of institutional and infrastructural harmonisation in the production of biometric population registers in Ghana.
Using particle-in-cell simulations, we demonstrate an improvement of the target-normal-sheath acceleration (TNSA) of protons in non-periodically nanostructured targets with micron-scale thickness. Compared to standard flat foils, an increase in the proton cutoff energy by up to a factor of two is observed in foils coated with nanocones or perforated with nanoholes. The latter nano-perforated foils yield the highest enhancement, which we show to be robust over a broad range of foil thicknesses and hole diameters. The improvement of TNSA performance results from more efficient hot-electron generation, caused by a more complex laser–electron interaction geometry and increased effective interaction area and duration. We show that TNSA is optimized for a nanohole distribution of relatively low areal density and that is not required to be periodic, thus relaxing the manufacturing constraints.