Wirksamkeit eines spezifisch für Zwangsstörungen entwickelten stationären Gruppentherapiekonzepts bei gleichzeitiger Verhaltenstherapie und pharmakologischer Behandlung

Purpose: The goal of this treatment trial was to investigate the efficacy of an inpatient group therapy program specifically designed for patients suffering from Obsessive Compulsive Disorder (OCD, ICD 10, F 42). Methods: In the experimental group (EG; n = 14) the specific group therapy was carried out in addition to individual cognitive-behavioral therapy, the control group (KG; n = 16) received non-specific group therapy in mixed patient-groups in addition to individual therapy. 7 patients (EG = 3, KG = 4) received also Selective Serotonin re-uptake inhibitors (SSRIs). Y-BOCS, BDI, and STAI-X1 were performed pre- and post-treatment. Furthermore therapists' ratings and self ratings were taken. Results: At post-treatment both groups showed significant improvement of the symptomatology. For the EG the Y-BOCS mean was reduced from 23.64 to 11.35, for the KG from 23.81 to 12.81. The group comparison showed no significant differences (alpha = 0.05) in clinical measurements, therapists' and self ratings. However, there were significantly more responders (improvement >50%, Y-BOCS) in the EG and treatment duration was shorter by 15 days. Conclusions: Clinical outcome in the EG was not superior. However, the specific group therapy for OCD contributes to an economic and effective treatment

Are planetary nebulae derived from multiple evolutionary scenarios?

Our understanding of planetary nebulae has been significantly enhanced as a result of several recent large surveys (Parker et al., these proceedings). These new discoveries suggest that the `PN phenomenon' is in fact more heterogeneous than previously envisaged. Even after the careful elimination of mimics from Galactic PN catalogues, there remains a surprising diversity in the population of PNe and especially their central stars. Indeed, several evolutionary scenarios are implicated in the formation of objects presently catalogued as PNe. We provide a summary of these evolutionary pathways and give examples of each. Eventually, a full census of local PNe can be used to confront both stellar evolution theory and population synthesis models.Comment: 4 pages, 1 figure. To be published in Planetary Nebulae: an Eye to the Future, Proceedings of IAU Symposium 283, held in Puerto de la Cruz, Tenerife, Spain, July 25-29 201

Strong Depth-Related Zonation of Megabenthos on a Rocky Continental Margin (∼700–4000 m) off Southern Tasmania, Australia

Assemblages of megabenthos are structured in seven depth-related zones between ~700 and 4000 m on the rocky and topographically complex continental margin south of Tasmania, southeastern Australia. These patterns emerge from analysis of imagery and specimen collections taken from a suite of surveys using photographic and in situ sampling by epibenthic sleds, towed video cameras, an autonomous underwater vehicle and a remotely operated vehicle (ROV). Seamount peaks in shallow zones had relatively low biomass and low diversity assemblages, which may be in part natural and in part due to effects of bottom trawl fishing. Species richness was highest at intermediate depths (1000–1300 m) as a result of an extensive coral reef community based on the bioherm-forming scleractinian Solenosmilia variabilis. However, megabenthos abundance peaked in a deeper, low diversity assemblage at 2000–2500 m. The S. variabilis reef and the deep biomass zone were separated by an extensive dead, sub-fossil S. variabilis reef and a relatively low biomass stratum on volcanic rock roughly coincident with the oxygen minimum layer. Below 2400 m, megabenthos was increasingly sparse, though punctuated by occasional small pockets of relatively high diversity and biomass. Nonetheless, megabenthic organisms were observed in the vast majority of photographs on all seabed habitats and to the maximum depths observed - a sandy plain below 3950 m. Taxonomic studies in progress suggest that the observed depth zonation is based in part on changing species mixes with depth, but also an underlying commonality to much of the seamount and rocky substrate biota across all depths. Although the mechanisms supporting the extraordinarily high biomass in 2000–2500 m depths remains obscure, plausible explanations include equatorwards lateral transport of polar production and/or a response to depth-stratified oxygen availability

Suizidprävention: Vorgehensweisen und Wirksamkeit

According to official statistics every year 11,000 persons in Germany die from suicide. 20 years ago nearly 19,000 suicides were registered. What are the causes for this decrease? Do suicide preventive measures contribute to the reduction of suicide rates? Different universal prevention strategies ( e. g. restriction of access to means) and selective approaches ( programs for special high-risk groups; e. g. patients after attempted suicide) are presented and discussed regarding their preventive value. In most cases it is hardly possible to scientifically prove the efficacy of suicide prevention strategies. Neither the role of psychosocial interventions nor the impact of psychotropic agents can be sufficiently quantified. Due to various methodological reasons ( e. g. small sample sizes and the lack of randomization), interpretation of the data is difficult. In terms of a comprehensive approach of suicide prevention a combination of different activities should be most adequate in the long run

Games and gamification projects in the Australian public sector

This article surveys the arrival of gameful government into Australian public sector practice. Gameful government is a shorthand, descriptive term denoting the interpenetration of (video)games, and design elements and thinking from them, into public sector work. Knowledge of gameful government is limited, in Australia and internationally, due to localised usage, low visibility, and limited understanding beyond informed observers. Our study partially redresses this under‐exploration of public sector games and gamification, both empirically and ethically. To do so, we detail the history of gaming for public sector purposes, a story starting with wargaming. Then, we categorise past and current gameful Australian public sector projects into a typology with five categories: recruitment; training and learning; public communication and policy education; engagement; and implementation and evaluation. We analyse the typology categories and characteristic cases within them. Finally, we assess the benefits and risks of gameful government for citizens and public sector practice. Points for practitioners: Knowledge, skills, and practices from (video)game play and development are increasingly prevalent within the Australian public sector. This article descriptively terms this gameful government. Despite a range of current use cases—for recruitment, training and learning, public communication and policy education, public engagement, implementation, and evaluation—Australian public sector examples are localised, particularly in Defence. Realising the potential of games for public sector and societal ends will require broader acknowledgement and understanding of this practice, as part of larger shifts in public sector capability and technological transformation

Das "Nürnberger Bündnis gegen Depression"

Background: Recent studies showed the increasing importance of depressive disorders. Despite good treatment possibilities (pharmacological treatment and psychotherapy) only a minority of patients receive adequate treatment. One of the most dramatic consequences is a big number of suicides. Methods: Within the competence network on depression and suicidality (founded by the German Ministry for Education and Research) a multi-level program was carried out in 2001 and 2002: the “Nuremberg Alliance against Depression”. In the centre of the activities was the optimisation of diagnosis and therapy in primary care. Family doctors received continuous education and different screening tools were established. Brochures and videos were produced to improve patients` knowledge of symptoms, causes and treatment possibilities. Besides that an intense information campaign was started (posters, lectures, cinema spot, leaflets etc.). Moreover a close cooperation with other community facilitators (priests, geriatric nurses, teachers etc.) should improve awareness towards depression and suicidality. Finally, special support for patients and their relatives was provided. A telephone hotline for persons after suicide attempt offered help in the case of a further suicidal crisis. Main outcome criteria of the study was the reduction of suicidal acts (suicides and suicide attempts) in comparison to a baseline-year (2000) and a control region (Wuerzburg). Results: The results for the first year of intervention (2001) show a significant decrease of suicidal acts in Nuremberg compared to the baseline and to the control region. Suicidal acts dropped from 620 cases to 500 cases (p=0.046). The decrease of persons committing a suicide attempt was 21.6% (375 vs. 475 cases) and differed significantly from the control region (p=0.008). Completed suicides decreased from 100 to 75 (-25%) which was not significant compared to the control region where a similar reduction in suicide rates was observed.Hintergrund: Studien in der jüngeren Vergangenheit haben nachhaltig auf die große Bedeutung depressiver Störungen aufmerksam gemacht. Obwohl vor allem mit Pharmakotherapie und Psychotherapie seit langer Zeit erprobte und bewährte Behandlungsmöglichkeiten vorliegen, erhalten derzeit nur rund 10% der Betroffenen eine entsprechende Therapie. Eine der drastischsten Folgen von unzureichend behandelten Depressionen ist eine hohe Exzessmortalität. Fragestellung und Methode: Im Rahmen des Kompetenznetzes „Depression, Suizidalität“ (gefördert vom Bundesministerium für Bildung und Forschung BMBF) wurde von 2001 bis 2002 ein kontrolliertes depressionspräventives 4-Ebenen-Programm durchgeführt: das „Nürnberger Bündnis gegen Depression“. Im Zentrum der Aktivitäten stand eine Optimierung der Diagnose und Therapie in der Primärversorgung. Hausärzte wurden intensiv geschult. Ihnen wurden Screeninginstrumente zur Verfügung gestellt und umfangreiches Informationsmaterial zur Weitergabe an Patienten angeboten (z.B. Videos, Broschüren). Daneben fand eine öffentliche Informationskampagne statt (Plakate, Vorträge, Kinospot, Distribution von 100.000 Flyern etc.). Zudem gab es eine enge Kooperation mit weiteren Berufsgruppen, die sekundär in die Versorgung depressiver Patienten eingebunden sind (z.B. Pfarrer, Altenpflegekräfte, Sozialpädagogen etc.). Schließlich wurden spezielle Unterstützungsangebote für Betroffene gemacht. So wurde eine Telefonhotline für Menschen nach Suizidversuch eingerichtet, über die im Falle einer weiteren Krise schnelle Hilfe angeboten werden konnte. Als Haupterfolgskriterium der Studie wurde eine signifikante Reduktion der suizidalen Handlungen (Suizide + Suizidversuche) im Vergleich zu einer Baseline (Jahr 2000) und zu einer Kontrollregion (Würzburg) gewählt. Ergebnisse: Die Ergebnisse zeigen für das erste Interventionsjahr (2001) im Vergleich zur Baseline (2000) und zur Kontrollregion eine signifikante Abnahme suizidaler Handlungen in Nürnberg von 620 auf 500 Fälle (p=0,046). Der Rückgang der Suizidversuchsfälle betrug 21,6% (375 versus 475) und unterschied sich ebenfalls signifikant von der Kontrollregion (p=0,008). Im Vergleich zur Baseline konnte darüber hinaus eine Reduktion der Suizide um 25% von 100 auf 75 Fälle gezeigt werden, die insbesondere auf niedrigere Suizidraten bei den über 60-Jährigen zurückzuführen war. Da es in der Kontrollregion ebenfalls zu einer Reduktion der Suizide gekommen war, wurde hier Signifikanz verfehlt

Uplifting manhood to wonderful heights? News coverage of the human costs of military conflict from world war I to Gulf war Two

Domestic political support is an important factor constraining the use of American military power around the world. Although the dynamics of war support are thought to reflect a cost-benefit calculus, with costs represented by numbers of friendly war deaths, no previous study has examined how information about friendly, enemy, and civilian casualties is routinely presented to domestic audiences. This paper establishes a baseline measure of historical casualty reporting by examining New York Times coverage of five major wars that occurred over the past century. Despite important between-war differences in the scale of casualties, the use of conscription, the type of warfare, and the use of censorship, the frequency of casualty reporting and the framing of casualty reports has remained fairly consistent over the past 100 years. Casualties are rarely mentioned in American war coverage. When casualties are reported, it is often in ways that minimize or downplay the human costs of war

Satellite observations of cloud regime development: the role of aerosol processes

Abstract. Many different interactions between aerosols and clouds have been postulated, based on correlations between satellite retrieved aerosol and cloud properties. Previous studies highlighted the importance of meteorological covariations to the observed correlations. In this work, we make use of multiple temporally-spaced satellite retrievals to observe the development of cloud regimes. The observation of cloud regime development allows us to account for the influences of cloud fraction (CF) and meteorological factors on the aerosol retrieval. By accounting for the aerosol index (AI)-CF relationship, we reduce the influence of meteorological correlations compared to "snapshot" studies, finding that simple correlations overestimate any aerosol effect on CF by at least a factor of two. We find an increased occurrence of transitions into the stratocumulus regime over ocean with increases in MODIS AI, consistent with the hypothesis that aerosols increase stratocumulus persistence. We also observe an increase in transitions into the deep convective regime over land, consistent with the aerosol invigoration hypothesis. We find changes in the transitions from the shallow cumulus regime in different aerosol environments. The strength of these changes is strongly dependent on Low Troposphere Static Stability and 10 m windspeed, but less so on other meteorological factors. Whilst we have reduced the error due to meteorological and CF effects on the aerosol retrieval, meteorological covariation with the cloud and aerosol properties is harder to remove, so these results likely represent an upper bound on the effect of aerosols on cloud development and CF. </jats:p

Next‐generation sequencing for the diagnosis of MYH9 ‐RD: Predicting pathogenic variants

The heterogeneous manifestations of MYH9 ‐related disorder (MYH9‐RD), characterized by macrothrombocytopenia, Döhle‐like inclusion bodies in leukocytes, bleeding of variable severity with, in some cases, ear, eye, kidney, and liver involvement, make the diagnosis for these patients still challenging in clinical practice. We collected phenotypic data and analyzed the genetic variants in more than 3,000 patients with a bleeding or platelet disorder. Patients were enrolled in the BRIDGE‐BPD and ThromboGenomics Projects and their samples processed by high throughput sequencing (HTS). We identified 50 patients with a rare variant in MYH9 . All patients had macrothrombocytes and all except two had thrombocytopenia. Some degree of bleeding diathesis was reported in 41 of the 50 patients. Eleven patients presented hearing impairment, three renal failure and two elevated liver enzymes. Among the 28 rare variants identified in MYH9 , 12 were novel. HTS was instrumental in diagnosing 23 patients (46%). Our results confirm the clinical heterogeneity of MYH9 ‐RD and show that, in the presence of an unclassified platelet disorder with macrothrombocytes, MYH9 ‐RD should always be considered. A HTS‐based strategy is a reliable method to reach a conclusive diagnosis of MYH9 ‐RD in clinical practice.<br/