["EduKation demenz®". Psychoeducative training program for relatives of people with dementia]. / "EduKation demenz®". Psychoedukatives Schulungsprogramm für Angehörige von Menschen mit Demenz.

BACKGROUND: During the course of dementia there is frequently a decline in the quality of interpersonal relationships between the patient and the family caregivers. This is mainly caused by a very critical attitude of the family caregiver to the patient and by the limited ability of the family caregiver to empathically communicate with the patient. This relational disorder significantly contributes to the perceived burden of the family caregiver. OBJECTIVE: This study was carried out to investigate whether the ability of family caregivers to empathically communicate can be strengthened, their emotional attitude towards the patient can be improved and their perceived burden and symptoms of depression can be reduced through a special communication-oriented psychoeducational intervention. MATERIAL AND METHODS: Within the framework of a controlled study for confounding factors 121 family caregivers participated in a 10-week group intervention "EduKation demenz®," whereas the 93 family caregivers of the control group received detailed self-help literature. The before and after surveys were conducted using a standardized questionnaire. RESULTS: Compared to the control group the intervention group displayed a statistically significant difference in all target parameters: more empathic communication with the patient (confounder-controlled difference of change in the intervention group versus control group 0.69, p = 0.023), a less critical attitude towards the patient (confounder-controlled difference of change in the intervention group versus control group 2.11, p = 0.027), reduction in the perceived burden from disrupted communication (confounder-controlled difference of change in the intervention group versus control group 1.76, p = 0.038) and decreased symptoms of depression for caregivers with ≥ 33 points in the general depression scale (ADS-K, p = 0.028). CONCLUSION: Family caregivers of people with dementia clearly did not benefit from direct information transfer through the extensive offer of self-help literature to the same extent as the psychoeducational group intervention.

Fracture Rates and Lifetime Estimations of CAD/CAM All-ceramic Restorations.

The gathering of clinical data on fractures of dental restorations through prospective clinical trials is a labor- and time-consuming enterprise. Here, we propose an unconventional approach for collecting large datasets, from which clinical information on indirect restorations can be retrospectively analyzed. The authors accessed the database of an industry-scale machining center in Germany and obtained information on 34,911 computer-aided design (CAD)/computer-aided manufacturing (CAM) all-ceramic posterior restorations. The fractures of bridges, crowns, onlays, and inlays fabricated from different all-ceramic systems over a period of 3.5 y were reported by dentists and entered in the database. Survival analyses and estimations of future life revealed differences in performance among ZrO2-based restorations and lithium disilicate and leucite-reinforced glass-ceramics.

[Musculoskeletal symptoms in patients with post-polio syndrome]. / Orthopädische Beschwerden und Funktionseinschränkungen beim Post-Polio-Syndrom.

BACKGROUND: The prevalence of the post-polio syndrome (PPS) is in estimated 50 % of persons with established poliomyelitis with a subsequently stable phase of at least 15 years. The basic mechanism is a loss of motoneuron cells in the spinal cord resulting in muscle weakness and fatigue. In addition pain, cold intolerance and a loss of stamina are frequently reported. There are few studies focusing on the orthopaedic symptoms in the PPS. This study should support the health-care professionals to the address the needs of PPS patients. METHODS: A questionnaire was developed to collect data on patients who have been diagnosed by a neurologist as fulfilling the criteria of a PPS. It consists of two parts. In the first part, general patient data are collected. In the second part, details of health, pain, and activities of daily living are collected at two points in time: the time of the stable phase immediately after the acute phase of the disease and the phase after the PPS diagnosis. The questionnaires were sent to patients with a diagnosis of PPS. A total of 124 questionnaires were analysed (male: 45, female: 79). Parts of the data were used to calculate a score. It was hypothesised that the score would demonstrate a higher load of orthopaedic symptoms in the PPS phase. RESULTS: The results show that the phase after poliomyelitis (stable phase vs. PPS phase) was associated with significantly different sum score relating to the orthopaedic impairments. The score in the stable phase is on average 18.6 units lower than that in the post-PPS diagnosis phase (p < 0.001). The hypothesis that in the PPS phase the load of orthopaedic symptoms is increased is confirmed by our data. The "loss of functioning in the upper extremity" is also significantly associated with the score (p = 0.004). CONCLUSIONS: At the time the survey was taken, patients reveal a high level of musculoskeletal impairments and disabilities after PPS than during the stable phase with regard to general health as well as pain status and performance of daily activities. Age has no significant impact. Many of the patients are severely limited, especially with regard to activities such as walking, climbing stairs, and performing simple household tasks. Since there is no causal therapy for the underlying degeneration of the anterior horn cell pools, treatment is focused on the compensation of the functional limitations.

The importance of knowing when to stop. A sequential stopping rule for component-wise gradient boosting.

OBJECTIVES: Component-wise boosting algorithms have evolved into a popular estimation scheme in biomedical regression settings. The iteration number of these algorithms is the most important tuning parameter to optimize their performance. To date, no fully automated strategy for determining the optimal stopping iteration of boosting algorithms has been proposed. METHODS: We propose a fully data-driven sequential stopping rule for boosting algorithms. It combines resampling methods with a modified version of an earlier stopping approach that depends on AIC-based information criteria. The new "subsampling after AIC" stopping rule is applied to component-wise gradient boosting algorithms. RESULTS: The newly developed sequential stopping rule outperformed earlier approaches if applied to both simulated and real data. Specifically, it improved purely AIC-based methods when used for the microarray-based prediction of the recurrence of metastases for stage II colon cancer patients. CONCLUSIONS: The proposed sequential stopping rule for boosting algorithms can help to identify the optimal stopping iteration already during the fitting process of the algorithm, at least for the most common loss functions.