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With respect to mental health disorders, there are cultural and migration-related differences in the personal experience and the way of dealing with them. However, the association between migration experiences and the development and the continuation of mental health disorders respectively, remain unclear. Epidemiological studies on mental health disorders of migrants rarely exist, even though such information is decisive for the appropriate medical care of this target group. We therefore conducted a cross-sectional survey regarding mental health of immigrants in Germany attending in non-health specific counseling agencies of welfare associations. Besides somatization symptoms (Beschwerdeliste (BL)) and symptoms of mental disorders (depression: patients’ health questionnaire (PHQ-D); anxiety: GAD-7; hazardous alcohol consumption: AUDIT), data on the social and occupational situation, as well as on the migration background was acquired. Data of n= 506 immigrants (55.5% female) were analyzed (age: 54.7 ± 12.4). The immigrants stems from the states of the former Soviet Union (n= 196), Turkey (n= 77), Italy (n= 95) and Spain (n= 67). Overall, 27.1% show evidence for a somatization disorder, 15.8% for a depressive disorder and 23.1% for increased anxiety (GAD-7 ≥ 5). 16.0% of the respondents show evidence of hazardous alcohol consumption. The study provides empirically profound information about the mental health of immigrants, who attend non-health specific counseling agencies. The analysis, subject to the migration status and socio-demographic factors, allows the development of measures of the enhancement of health care for this group regarding mental health.
To detect eating disorders and risky eating behaviour in early stages, screening tests are used. In order to examine as many adolescents as possible, these tests should be economic, i. e. as short as possible but at the same time they should fulfil the psychometric quality criteria. We compared the German version of the Eating Attitudes Test (EAT-26D) and the German version of the SCOFF test (which contains only five Yes-no questions) in a sample of 425 twelve year old girls and 382 boys from Thuringia, Germany. Although the EAT-26D reached higher psychometric properties, the SCOFF has been proved as a useful screening tool with a test-retest reliability of rtt = .73 and a maximum accuracy of 82% (area under the ROC curve). In reference to the EAT-26D (20 point cut-off) the sensitivity of the SCOFF was 78%, specificity 75%, positive predictive value 28%, and the negative predictive value, which is more relevant for screenings, was 96%. The construct validity reached r = .52.
Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.
Method
Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.
Results
A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29–0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit–risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.
Conclusions
Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains.
Method
We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons).
Results
One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (pdiscovery = 3.82 × 10−8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (pdiscovery+replication = 1.10 × 10−6) with evidence of heterogeneity.
Conclusions
Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.
It is well known that web-based interventions can be effective treatments for depression. However, dropout rates in web-based interventions are typically high, especially in self-guided web-based interventions. Rigorous empirical evidence regarding factors influencing dropout in self-guided web-based interventions is lacking due to small study sample sizes. In this paper we examined predictors of dropout in an individual patient data meta-analysis to gain a better understanding of who may benefit from these interventions.
Method
A comprehensive literature search for all randomized controlled trials (RCTs) of psychotherapy for adults with depression from 2006 to January 2013 was conducted. Next, we approached authors to collect the primary data of the selected studies. Predictors of dropout, such as socio-demographic, clinical, and intervention characteristics were examined.
Results
Data from 2705 participants across ten RCTs of self-guided web-based interventions for depression were analysed. The multivariate analysis indicated that male gender [relative risk (RR) 1.08], lower educational level (primary education, RR 1.26) and co-morbid anxiety symptoms (RR 1.18) significantly increased the risk of dropping out, while for every additional 4 years of age, the risk of dropping out significantly decreased (RR 0.94).
Conclusions
Dropout can be predicted by several variables and is not randomly distributed. This knowledge may inform tailoring of online self-help interventions to prevent dropout in identified groups at risk.
Patients exhibiting considerable blood loss are prone to develop dilutional coagulopathy following volume supply. In such patients, in addition to transfusing stored blood components, cell saver systems are used to minimize allogeneic transfusion. Since red cell transfusion might influence the haemostatic system by further dilution, we investigated the effects of re-transfusion of salvaged washed red blood cells on the haemostatic process in an animal model of controlled haemorrhage using rotational thrombelastometry (ROTEM®; Pentapharm Co., Munich, Germany).
Methods
Anaesthetized pigs (n = 20) developed coagulopathy following haemorrhagic shock (withdrawal of 66% of estimated blood volume) and volume resuscitation with 6% hydroxyethyl starch 130/0.4. The shed blood was processed in a Cellsaver device (CATS ®; Fresenius AG, Bad Homburg, Germany), and the resulting salvaged red blood cells were re-transfused. ROTEM assays were performed at baseline, after blood loss, after volume resuscitation and following re-transfusion of salvaged red blood cells.
Results
As compared with baseline, blood loss and subsequent volume resuscitation resulted in significantly increased median values of clotting time (CT: 47.0, 5 .3 and 103.5 s), and clot formation time (CFT: 36.0, 40.0 and 186.0 s), whigggle maximum clot firmness decreased (MCF: 72.0, 68.5 and 39.5 mm). After re-transfusion of salvaged red blood cells (805 ± 175 mL) all these parameters improved (CT: 80.5 s; P = 0.05, CFT: 144.0 s; P = 0.0008, MCF: 42.0 mm; P = 0.0019) although baseline values were not reached.
Conclusion
In the case of extreme isovolaemic haemodilution, increasing the circulating red cell mass by re-transfusing salvaged red blood cells did not worsen the findings of dilutional coagulopathy but interestingly, at least partially, improves the clot formation process.
In 2005 we obtained very precise interferometric measurements of the pole-on rapid rotator Vega (A0 V) with the longest baselines of the Center for High Angular Angular Resolution (CHARA) Array and the Fiber Linked Unit for Optical Recombination (FLUOR). For the analysis of these data, we developed a code for mapping sophisticated PHOENIX model atmospheres on to the surface of rotationally distorted stars described by a Roche-von Zeipel formalism. Given a set of input parameters for a star or binary pair, this code predicts the interferometric visibility, spectral energy distribution and high-resolution line spectrum expected for the system. For the gravity-darkened Vega, our model provides a very good match to the K-band interferometric data, a good match to the spectral energy distribution – except below 160 nm – and a rather poor match to weak lines in the high dispersion spectrum where the model appears overly gravity darkened. In 2006, we used the CHARA Array and FLUOR to obtain high precision measurements of the massive, non-eclipsing, double-line spectroscopic binary Spica, a 4-day period system where both components are gravity darkened rapid rotators. These data supplement recent data obtained with the Sydney University Stellar Interferometer (SUSI). Our study follows the classic 1971 study by Herbison-Evans et al. who resolved Spica as a binary with the Narrabri Stellar Intensity Interferometer (NSII). We will report on our progress modeling the new interferometric and archival spectroscopic data, with the goal towards better constraining the apsidal constant.
The substitution sites of Pb and Dy dopants in the cuprate-type high temperature superconductor Bi2Sr2Ca1Cu2O
$_{8+\delta}$
are determined by a direct comparison of the angle-scanned X-ray photoelectron diffraction (XPD) patterns. We demonstrate the power of XPD as a fingerprinting tool and conclude that Pb occupies Bi sites and Dy the Ca sites. The presence of the incommensurate lattice modulation is not visible in XPD, probably due to a Pb-induced, reduced modulation amplitude.
Microstructure studies of ultra-thin BaTiO3 thin films (2-10 nm thick) show nano-domains having a width as small as one unit cell. Only 180° nano-domains are formed in multi-domains structures. The domain-boundaries are formed at {001} twin boundaries. Most of the domains are oriented in parallel to the film plane but out-of-plane orientations are also observed. The films exhibit ferroelectric behavior characterized by a polarization hysteresis loop and a relatively fast switching time. A remnant polarization of about 0.5 μC/cm2 and coercive field of 2.7 V/cm were measured in parallel to the film plane. Temperature-dependent measurements show two peaks of the dielectric constant at about 60°C and 115°C. These peaks are attributed to two transition temperatures associated with the orientation of the nano-domains relative to the film plane and stress.
Co/Pt thin film multilayers with strong perpendicular anisotropy and out-of-plane coercivities of 5-11 kOe were magnetically altered in areas of local ion beam interaction. The ion irradiations were performed by ion projection through silicon stencil masks fabricated by silicon on insulator (SOI) membrane technology. The ion projector at the Fraunhofer Institute for Silicon Technology (ISiT) was operated at 73 keV ion energy and with a 8.7- fold demagnification. After exposure to 3 × 1014Ar+/ cm2 magnetic islands smaller than 100 nm in diameter were resolved in the Co/Pt multilayersby means of magnetic force microscopy. The impact of different ion species (He+, Ar+ and Xe+) and ion energies (10 – 200 keV) on the multilayer structure was evaluated using Monte Carlo simulations. The ballistic interface intermixing was used to predict magnetic coercivity changes for various irradiation conditions. The simulations revealed that with 73 keV Ar+ and Xe+ ions the irradiation dose could be reduced by a factor of 100 and 400 respectively in comparison to 73 keV He+which was verified in the experiments. X-ray reflectivity measurements confirmed that the Co/Pt superlattice structure is slightly weakened during the irradiation and that the surface smoothness of the media is preserved. Using the Ion Projection Process Development Tool (PDT) at IMS-Vienna concentric data tracks including head positioning servo informations were patterned onto a 1” IBM microdrive™ glass disk which was coated with Co/Pt multilayers. In a single exposure step several tracks within an exposure field of 17 mm in diameter were structured by 2 × 1015He+/ cm2 at 45 keV using a 4- fold demagnification set-up.