RÉSUMÉ
BACKGROUND: Increasing the effectiveness of psychosomatic rehabilitation by prolonging the treatment is a subject of controversial debate. The number of sessions over time defines the dosage in psychotherapy. While the dose-response model assumes an optimal therapy dose, the good-enough level model assumes a correlation of the rate of change with the total sessions. A randomized control group study was conducted to investigate the extent to which an adaptive therapy concept with a two-week intensive phase and early intervention could increase rehabilitation success. METHOD: A total of 494 rehabilitants between the ages of 21 and 64 (47% women) who completed a classical or an integrative psychosomatic rehabilitation at the Rehazentrum Oberharz between 2020 and 2022 were analysed. Rehabilitation success was mapped by the Reliable Change Index of individual symptom reduction (depression severity or psychological and somatoform disorders) and as a socio-medical parameter (physician's assessment of potential work ability (WA) after two weeks). Two-factorial ANOVAs and hierarchical binary logistic regressions were calculated, and sick leave before rehabilitation was statistically controlled. RESULTS: Dosage showed no effect on symptom reduction (pâ¯= 0.29) and potential WA after two weeks (pâ¯= 0.90). However, when stratified by disease severity, there was a mean effect of dosage (pâ¯= 0.05) and twice the probability of WA after two weeks (odds 2.13; pâ¯= 0.01) for those with mild disease at the start of measure (pâ¯= 0.05). DISCUSSION: In the early stages of an affective disorder, early and intensified intervention can counteract the chronification of mental disorders.
Sujet(s)
Troubles psychosomatiques , Psychothérapie , Humains , Femelle , Mâle , Adulte , Adulte d'âge moyen , Troubles psychosomatiques/rééducation et réadaptation , Troubles psychosomatiques/psychologie , Psychothérapie/méthodes , Allemagne , Résultat thérapeutique , Jeune adulte , Troubles mentaux/rééducation et réadaptation , Troubles mentaux/psychologieRÉSUMÉ
In the project "Resilient Children", a resilience promotion program for kindergartens and elementary schools was directly applied and evaluated during the COVID-19-crisis.The aim of the study was to strengthen the three sources of resilience according to Grotberg (1995) I HAVE, I AM and I CAN through targeted exercises and resilience-promoting communication (transfer to everyday life). Additionally, gender differences with regard to the effect of the programme were addressed. "Resilient Children" was evaluated at the impact level (pre-post design) and process level. Eight kindergartens and three elementary schools with 125 children participated. A total of 122 teachers and 70 parents provided information about the children. The results at the impact level showed that from the parent and teacher perspective, and from the self-perspective (children), the three sources of resilience were significantly strengthened. With regard to gender differences, the results from the perspective of teachers and parents showed that girls were characterised by greater changes than boys. Compared to the girls, the physical andmental well-being of the boys improved fromthe parents' point of view. The results of the process evaluation revealed a high level of motivation and enthusiasm for participation in the programme on the part of participating children and teachers. The success of "Resilient Children" depends on the identification of the teachers with the program.
Sujet(s)
COVID-19 , Mâle , Femelle , Humains , Enfant , Évaluation de programme , Établissements scolaires , Niveau d'instruction , MotivationRÉSUMÉ
PURPOSE: Rehabilitation success is directly reflected in individual symptom reduction and indirectly in sociomedical benefits. The findings on the extension of measures to increase rehabilitation success are controversial. Treatment duration does not seem to be a sufficient predictor of rehabilitation success. Long periods of sick leave may contribute to chronification of mental illness. The study examined the relationship between the duration of sick leave before psychosomatic rehabilitation (less vs. more than 3 months) with different depression severity at the start of rehabilitation (below vs. above clinical relevance) and (un)indirect rehabilitation success. For this purpose, 1612 rehabilitants aged 18-64 years, 49% women, who completed psychosomatic rehabilitation at the Oberharz Rehabilitation Centre in 2016 were examined. METHODS: Individual symptom reduction was mapped by the Reliable Change Index (consid-ered as a good estimator of true change) from pre/post test scores of the BDI-II. Periods of sick leave before rehabilitation and insurance/contribution periods one to four years after rehabilitation were taken from the accounts of Deutsche Rentenversicherung Braunschweig-Hannover. Multiple hierarchical regression, repeated measures 2-factorial ANCOVAs, planned contrasts, were calculated. Age, gender and rehabilitation duration were statistically controlled. RESULTS: A multiple hierarchical regression showed incremental variance clarification in symptom reduction for patients who were on sick leave for less than three months before rehabilitation (4%) and for those who started rehabilitation with clinically relevant depression (9%) with medium and large effect sizes, (respectively f2=0,22 and 0,73). Repeated-messures 2-factorial ANCOVAs showed, more contributions/contribution periods for patients with a short period of sick leave before rehabilitation in each year after rehabilitation, with small effect size (ηp 2=0,03 and 0,02). Patients starting rehabilitation with low depression severity showed more insurance but not more contribution periods in the same period (ηp 2=0,01). CONCLUSION: Duration of incapacity for work before rehabilitation appears to be an important pa-rameter for (un)direct rehabilitation success. Future studies should further differentiate and evaluate the effect of early admission within the first months of sick leave in psychosomatic rehabilitation measures.
Sujet(s)
Troubles mentaux , Troubles psychosomatiques , Humains , Femelle , Mâle , Troubles psychosomatiques/psychologie , Troubles mentaux/psychologie , Emploi , Centres de rééducation et de réadaptation , Congé maladieRÉSUMÉ
Traces of microbial volatile organic compounds (MVOCs) in air can indicate the presence of growth of moulds in the indoor environment. Ion-mobility spectrometry is a very promising method for detection of these MVOCs, because of its high sensitivity. For development of an in-situ method for detection of MVOCs, a portable ion-mobility spectrometer (IMS) was used and test gases of 14 MVOCs and their respective mixtures were investigated. IMS spectra were recorded as a function of concentration of MVOCs in air. Drift time and mobility of reactant ions formed in positive polarity mode were determined and correlated with the mass-to-charge ratio (m/z) of the MVOCs investigated. The estimated detection limit has a specific value for each MVOC and is in the range 3 to 96 microg m(-3) (1 to 52 ppb(V)). Indoor trials show that IMS can indicate hidden mould growth.
Sujet(s)
Bactéries/métabolisme , Analyse spectrale/méthodes , Composés organiques volatils/composition chimiqueRÉSUMÉ
In 2005 the then ESA Directorate for Human Spaceflight, Microgravity and Exploration (D-HME) commissioned a study from the European Science Foundation's (ESF) European Space Sciences Committee (ESSC) to examine the science aspects of the Aurora Programme in preparation for the December 2005 Ministerial Conference of ESA Member States, held in Berlin. A first interim report was presented to ESA at the second stakeholders meeting on 30 and 31 May 2005. A second draft report was made available at the time of the final science stakeholders meeting on 16 September 2005 in order for ESA to use its recommendations to prepare the Executive proposal to the Ministerial Conference. The final ESSC report on that activity came a few months after the Ministerial Conference (June 2006) and attempted to capture some elements of the new situation after Berlin, and in the context of the reduction in NASA's budget that was taking place at that time; e.g., the postponement sine die of the Mars Sample Return mission. At the time of this study, ESSC made it clear to ESA that the timeline imposed prior to the Berlin Conference had not allowed for a proper consultation of the relevant science community and that this should be corrected in the near future. In response to that recommendation, ESSC was asked again in the summer of 2006 to initiate a broad consultation to define a science-driven scenario for the Aurora Programme. This exercise ran between October 2006 and May 2007. ESA provided the funding for staff support, publication costs, and costs related to meetings of a Steering Group, two meetings of a larger ad hoc group (7 and 8 December 2006 and 8 February 2007), and a final scientific workshop on 15 and 16 May 2007 in Athens. As a result of these meetings a draft report was produced and examined by the Ad Hoc Group. Following their endorsement of the report and its approval by the plenary meeting of the ESSC, the draft report was externally refereed, as is now normal practice with all ESSC-ESF reports, and amended accordingly. The Ad Hoc Group defined overarching scientific goals for Europe's exploration programme, dubbed "Emergence and co-evolution of life with its planetary environments," focusing on those targets that can ultimately be reached by humans, i.e., Mars, the Moon, and Near Earth Objects. Mars was further recognized as the focus of that programme, with Mars sample return as the recognized primary goal; furthermore the report clearly states that Europe should position itself as a major actor in defining and leading Mars sample return missions. The report is reproduced in this article. On 26 November 2008 the Ministers of ESA Member States decided to give a high strategic priority to the robotic exploration programme of Mars by funding the enhanced ExoMars mission component, in line therefore with the recommendations from this ESSC-ESF report.
Sujet(s)
Agences internationales , Sociétés savantes , Vol spatial , Astronaute , Europe , Environnement extraterrestre , Objectifs , Humains , Coopération internationale , Mars , Planètes mineures , Lune , RobotiqueRÉSUMÉ
Millimetre wave therapy (MWT) is a promising complementary method for pain relief, however rigorous investigations of its effectiveness are needed. The purpose of this study was to examine if MWT can reduce opioid requirement compared to sham procedure applied for relief of acute pain in patients after total knee arthroplasty (TKA). Eighty patients undergoing TKA were randomly assigned to receive MWT or sham procedure. Patients and evaluators were blinded to the group allocation. MWT consisted of six sessions, each session of 30 min duration. During each session the knee wound was exposed to electromagnetic waves with frequency 50-75 GHz and power density 4.2 mW/cm(2). Postoperative analgesia with piritramide, a weak opioid with 0.7 potency of morphine delivered via patient-controlled analgesia pump, was directed to achieve pain intensity of less than 40 on a 100 mm visual analogue scale (VAS). The primary outcome measure was postoperative piritramide requirement for three days after surgery. Secondary outcome measures were: total ibuprofen requirement from the fourth postoperative day to discharge; success of patients' blinding; patients' satisfaction with pain relief; incidence of analgesia-related side effects; heart rate and blood pressure. Piritramide requirement was similar in both groups whereby all patients reported adequate pain relief measured on a VAS. Secondary outcome measures were also comparable in both groups. The majority of patients in both groups believed they had received true MWT and wanted to repeat it in future. Millimetre waves applied to surfaces of surgical wounds did not reduce opioid requirement compared to the sham procedure after TKA.