[Life Course Epidemiology and the Social Sciences: Living Apart Together?] / Lebenslaufforschung in der Epidemiologie und den Sozialwissenschaften. Gemeinsam einsam?

Life course influences are being increasingly considered as a key to better understanding of health and social inequalities in health. Our aim is to examine the potential of a broader interdisciplinary perspective on the life course and health, one that integrates sociological and psychological theory and generates greater dialogue between epidemiology and the social sciences. The paper reviews major principles and concepts applied in different disciplines that deal with life course and proposes a theory-driven research framework which better informs interdisciplinary exchange and illustrates how a bio-psycho-social perspective on life course can be infused more fully into epidemiology. The paradigmatic principles of interdisciplinary life course research (human agency, timing in lives, linked lives, historical context) provide a strong theoretical framework for a holistic and theory-based view of life course and its interdependent pathways. The stress process represents an important aetiological mechanism between the organising concepts of the life course and health. To better understand the development of health and health inequalities across the life course, an interdisciplinary approach is required. The suggested theoretical contributions to models of epidemiological life course research supplement the long appreciated methodological focus of the field and will encourage interdisciplinary dialogue.

[Challenges in the Analysis of Health Care Inequalities in Pediatric Rehabilitation]. / Herausforderungen in der Analyse von Versorgungsungleichheiten in der Kinderrehabilitation.

BACKGROUND: Social inequalities on access and utilization of inpatient rehabilitation among adolescents have rarely been studied. METHODS: Parents of children with chronic health conditions (age of 7-17) were interviewed about access and utilization of inpatient rehabilitation. Parents were recruited through pediatricians as well as rehabilitation centers in Central Germany. RESULTS: Despite of numerous recruitment measures the participation by pediatricians was low. Also expanding the sample did not remedial. Furthermore, fewer adolescents with need of rehabilitation were achieved than expected. The analysis is subject to these restrictions, nevertheless, they still allow explorative statements about access and utilization of pediatric rehabilitation. CONCLUSION: Despite major challenges in recruitment, pediatricians should be considered into analysis of inequalities in rehabilitation because of their gatekeeper function.

The course of the urinary DPD-crosslink secretion in metastatic breast cancer--a possibility for response assessment.

BACKGROUND: Urinary deoxypyridinoline (DPD)-crosslinks have been shown to be a highly specific parameter for type I collagen metabolism. MATERIALS AND METHODS: In a prospective breast cancer study, urine samples were collected in after-care patients and in patients with bone metastases. DPD-crosslinks were measured every three weeks using a fully automated chemiluminescence immunoassay. Bone metastases were confirmed by bone scan and/or x-ray, and were followed-up over six months. To validate the test, a receiver operating characteristics (ROC)-curve was set up to find the DPD cut-off concentration which separates patients with no evidence of disease (NED) from patients with bone metastases. RESULTS: 73 breast cancer patients (41 with NED, 32 with bone metastases) were included into the ROC analysis. At a DPD cut-off value of 8 nmol/mmol creatinine, we found the best sensitivity (84.4%) for the detection of bone metastases with a specificity of 70.7%. Patients with stable bone disease under intravenous pamidronate treatment (90 mg q3w) and specific therapy had a significant (p = 0.007) fall of the DPD-crosslinks in comparison to the progressive subset with 72.7% falling below 8 nmol/mmol. CONCLUSIONS: We conclude that the net bone turnover is not increased at a DPD-crosslinks elimination < 8 nmol/mmol.

Extraction of high quality DNA from bloodstains using diatoms.

A simple method is described for the extraction of high quality DNA for PCR amplification. The DNA was extracted by using Chelex-100 ion exchange resin or a special cell lysis buffer containing proteinase K. For further purification the DNA was bound to silica in the presence of a chaotrophic agent. Hence it is possible to unlimitedly wash the bound DNA and inhibitory substances are removed. By using diatoms as a source of silicates, this method is very economical and can therefore be used as a routine method.