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Hauptziel Adipositas ist eine der Hauptindikationen in der Kinder- und Jugend-Rehabilitation. Für ältere Jugendliche und junge Erwachsene fehlen altersspezifische Therapieangebote fast vollständig. Ziel war es die Wünsche bezüglich der Inhalte und Methoden einer „perfekten Therapie“ im Rahmen eines Rehabilitationsaufenthalts zu untersuchen.
Methode Im Rahmen der YOUTH-Studie wurden 147 adipöse Jugendliche und junge Erwachsene beiderlei Geschlechts (zwischen 15 und 21 Jahren) mithilfe eines standardisierten Fragebogens befragt.
Ergebnis Insgesamt zeigten sich relativ wenige alters- und geschlechtsspezifische Unterschiede. Interdisziplinär geleitete, koedukative Gruppen mit Elterneinbindung wurden gewünscht. Wichtige Themen waren gesunde Ernährung sowie psychosoziale Aspekte. Auch der Prävention von Rückfällen wurde eine hohe Relevanz zugeschrieben.
Schlussfolgerung Psychosoziale Aspekte und die Vorbereitung auf mögliche Rückfallsituationen sollten integraler Bestandteil der Therapie sein.
Battle of plates
(2017)
Objective: Approach-avoidance training (AAT) is a promising approach in obesity treatment. The present study examines whether an AAT is feasible and able to influence approach tendencies in children and adolescents, comparing implicit and explicit training approaches. Design/Setting/Subjects: Fifty-nine overweight children and adolescents (aged 8-16 years; twenty-six boys) participated in an AAT for food cues, learning to reject snack items and approach vegetable items. Reaction times in the AAT and an implicit association rest (IAT) were assessed pre- and post-intervention. Results: A significant increase in the AAT compatibility scores with a large effect (eta(2) = 0.18) was found. No differences between the implicit and explicit training approaches and no change in the IAT scores were observed. Conclusions: Automatic tendencies in children can be trained, too. The implementation of AAT in the treatment of obesity might support the modification of an unhealthy nutrition behaviour pattern. Further data from randomized controlled clinical trials are needed.
Clinical supervision is regarded as one of the most important components of psychotherapy training. In clinical practice, it has been found that the implementation of clinical supervision varies substantially and often differs from the recommendations made in the literature. The objective of the current study was to investigate the frequency of topics (e.g. ethical issues) and techniques (e.g. role play) in the clinical supervision of psychotherapy trainees in Germany. To this end, we considered supervisions in cognitive behavioural therapy (CBT) and psychodynamic therapy (PT). A total of 791 psychotherapy trainees (533 CBT and 242 PT) were asked via the internet to provide information about their current supervision sessions. We found that clinical supervision in psychotherapy training addressed topics that are central for the effective treatment of supervised patients (i.e. therapeutic interventions, therapeutic alliance, maintaining factors, and therapeutic goals). However, the most frequently used intervention in clinical supervision in psychotherapy training was case discussion. Rarely were techniques used that allowed the supervisor to give the supervisee feedback based on the supervisee's demonstrated competencies. For example, 46% of the supervisors never used audiotapes or videotapes in the supervision. Differences between CBT and PT were rather small. Current practice regarding the techniques used in clinical supervision for psychotherapy trainees contradicts recommendations for active and feedback-oriented clinical supervision. Thus the potential of clinical supervision might not be fully used in clinical practice.
Objective: Cognitive-behavioral therapy (CBT) has been shown to be effective in treating hypochondriasis. However, there are doubts regarding the long-term effectiveness of CBT for hypochondriasis, in particular for follow-up periods longer than 1 year. The aim of the present study was to evaluate the long-term effectiveness of cognitive therapy (CT) and exposure therapy (ET) for the treatment of hypochondriasis. Method: Seventy-five patients with a diagnosis of hypochondriasis who were previously treated with CT or ET were contacted 3 years after treatment. Fifty (67%) patients participated and were interviewed by an independent and blinded diagnostician using standardized interviews. Results: We found further improvements after therapy in primary outcome measures (d = .37), general functioning (d = .38), and reduced doctor visits (d = .30) during the naturalistic follow-up period. At the 3-year follow-up, 72% of the patients no longer fulfilled the diagnosis of hypochondriasis. Based on the main outcome measure, we found response rates of 76% and remission rates of 68%. At follow-up, only 4% of patients were taking antidepressant medication. Additional psychological treatment was utilized by 18% of the patients during the follow-up period (only 8% because of health anxiety). We found no overall differences between CT and ET. Only a trend for a greater deterioration rate in CT (13%) in comparison to ET (0%) was found. Conclusions: Our results suggest that 2/3 of the patients with hypochondriasis were remitted in the long term. Thus, remission rates after CBT were twice as high as in untreated samples.
Previous studies found high prevalence rates of personality disorders (PDs) in patients with hypochondriasis; however, assessment was often based only on questionnaires. In the current study, a sample of 68 patients with hypochondriasis was compared to 31 patients with panic disorder and to 94 healthy controls. Participants were investigated with the Structured Clinical Interview for DSM-IV Personality Disorders questionnaire (SCID-II questionnaire) and the SCID-II interview. Based on the cut-off scores of the SCID-II questionnaire, we found a prevalence rate of 45.6% for PD in patients with hypochondriasis. In comparison to healthy controls, patients with hypochondriasis showed characteristics of paranoid, borderline, avoid ant, and-dependent PDs in the dimensional assessment significantly more often. However, no significant differences were found between the clinical samples. Based on the SCID-II interview, only 2.9% of the patients with hypochondriasis fulfilled the criteria for a PD. These results suggest that PDs are not a specific characteristic of hypochondriasis.
The illness-related evaluation of bodily symptoms is considered to be an important maintaining factor in somatoform disorders. However, little is known about context variables that could influence this evaluation process. In the current study, participants completed three versions of the Health Norms Sorting Task (HNST) and evaluated bodily symptoms in different contexts (i.e., different evaluation perspectives and time frames of evaluation). Additionally, the three HNST versions were presented in different orders. Bodily symptoms were evaluated more often as a sign of illness when a specific time frame (i.e., one week) was given. However, this context effect was only large when participants had previously evaluated symptoms existing without a concrete duration. Thus, previously completed symptom evaluations appear to represent an important frame of reference in terms of a cue that makes specific context variables salient. The results further suggested that these cueing effects might be less relevant for participants with elevated somatic symptom reports.
This review analyzes the potential role and long-term effects of field perennial polycultures (mixtures) in agricultural systems, with the aim of reducing the trade-offs between provisioning and regulating ecosystem services. First, crop rotations are identified as a suitable tool for the assessment of the long-term effects of perennial polycultures on ecosystem services, which are not visible at the single-crop level. Second, the ability of perennial polycultures to support ecosystem services when used in crop rotations is quantified through eight agricultural ecosystem services. Legume-grass mixtures and wildflower mixtures are used as examples of perennial polycultures, and compared with silage maize as a typical crop for biomass production. Perennial polycultures enhance soil fertility, soil protection, climate regulation, pollination, pest and weed control, and landscape aesthetics compared with maize. They also score lower for biomass production compared with maize, which confirms the trade-off between provisioning and regulating ecosystem services. However, the additional positive factors provided by perennial polycultures, such as reduced costs for mineral fertilizer, pesticides, and soil tillage, and a significant preceding crop effect that increases the yields of subsequent crops, should be taken into account. However, a full assessment of agricultural ecosystem services requires a more holistic analysis that is beyond the capabilities of current frameworks.
Trait-based approaches have become increasingly successful in community ecology. They assume that the distribution of functional traits within communities responds in a predictable way to alterations in environmental forcing and that strong forcing may accelerate such trait changes. We used high frequency measurements of phytoplankton to test these assumptions. We analyzed the seasonal and long-term dynamics of the community trait mean within a multi-dimensional trait space under alternating multifactorial environmental conditions. The community trait mean exhibited a distinct recurrent annual pattern that reflected minor changes in climate, herbivory and nutrients. Independent of early spring conditions, the community trait mean was repeatedly driven into a narrow confined area in the trait space under pronounced herbivory during the clear water phase. The speed of movement was highest at the onset and the relaxation of such strong unidirectional forcing. Thus, our data support the conceptual framework of trait-based ecology that alterations in environmental conditions are systematically tracked by adjustments in the dominant functional trait values and that the speed of trait changes depends on the kind and intensity of the selection pressure. Our approach provides a sensitive tool to detect small functional differences in the community related to subtle differences in forcing.
The invasion success of the cyanobacterium Cylindrospermopsis raciborskii in experimental mesocosms
(2017)
The potentially toxic, invasive cyanobacterium Cylindrospermopsis raciborskii, originating from sub-tropical regions, has spread into temperate climate zones in almost all continents. Potential factors in its success are temperature, light and nutrient levels. Grazing losses through zooplankton have been measured in the laboratory but are typically not regarded as a factor in (failed) invasion success. In some potentially suitable lakes, C. raciborskii has never been found, although it is present in water bodies close by. Therefore, we tested the invasive potential of three different isolates introduced into natural plankton communities using laboratory mesocosm experiments under three grazing levels: ambient zooplankton densities, removal of large species using 100 mu m mesh and a ca. doubling of large species. Three C. raciborskii isolates originating from the same geographic region (North-East Germany) were added separately to the four replicates of each treatment and kept in semi-continuous cultures for 21 days. Two isolates disappeared from the mesocosms and were also not viable in filtered lake water indicating that the lake water itself or the switch from culture medium to lake water led to the decay of the inoculated C. raciborskii. Only one out of the three isolates persisted in the plankton communities at a rather low level and only in the treatment without larger zooplankton. This result demonstrates that under potentially suitable environmental conditions, top-down control from zooplankton might hamper the establishment of C. raciborskii. Non-metric multidimensional scaling showed distinct variation in resident phytoplankton communities between the different grazing levels, thus differential grazing impact shaped the resident community in different ways allowing C. raciborskii only to invade under competitive (= low grazing pressure) conditions. Furthermore, even after invasion failure, the temporary presence of C. raciborskii influenced the phytoplankton community.
Defensive behaviors in animals and humans vary dynamically with increasing proximity of a threat and depending upon the behavioral repertoire at hand. The current study investigated physiological and behavioral adjustments and associated brain activation when participants were exposed to dynamically approaching threat that was either inevitable or could be avoided by motor action. When the approaching threat was inevitable, attentive freezing was observed as indicated by fear bradycardia, startle potentiation, and a dynamic increase in activation of the anterior insula and the periaqueductal grey. In preparation for active avoidance a switch in defensive behavior was observed characterized by startle inhibition and heart rate acceleration along with potentiated activation of the amygdala and the periaqueductal grey. Importantly, the modulation of defensive behavior according to threat imminence and the behavioral option at hand was associated with activity changes in the ventromedial prefrontal cortex. These findings improve our understanding of brain mechanisms guiding human behavior during approaching threat depending on available resources.
Context. We map the interstellar medium (ISM) including the diffuse interstellar bands (DIBs) in absorption toward the globular cluster NGC6397 using VLT/MUSE. Assuming the absorbers are located at the rim of the Local Bubble we trace structures on the order of mpc (milliparsec, a few thousand AU). Aims. We aimed to demonstrate the feasibility to map variations of DIBs on small scales with MUSE. The sightlines defined by binned stellar spectra are separated by only a few arcseconds and we probe the absorption within a physically connected region. Methods. This analysis utilized the fitting residuals of individual stellar spectra of NGC6397 member stars and analyzed lines from neutral species and several DIBs in Voronoi-binned composite spectra with high signal-to-noise ratio (S/N). Results. This pilot study demonstrates the power of MUSE for mapping the local ISM on very small scales which provides a new window for ISM observations. We detect small scale variations in Na-I and K-I as well as in several DIBs within few arcseconds, or mpc with regard to the Local Bubble. We verify the suitability of the MUSE 3D spectrograph for such measurements and gain new insights by probing a single physical absorber with multiple sight lines.
There is growing empirical evidence that anthropogenic climate change will substantially affect the electric sector. Impacts will stem both from the supply sidethrough the mitigation of greenhouse gasesand from the demand sidethrough adaptive responses to a changing environment. Here we provide evidence of a polarization of both peak load and overall electricity consumption under future warming for the worlds third-largest electricity marketthe 35 countries of Europe. We statistically estimate country-level doseresponse functions between daily peak/total electricity load and ambient temperature for the period 2006-2012. After removing the impact of nontemperature confounders and normalizing the residual load data for each country, we estimate a common doseresponse function, which we use to compute national electricity loads for temperatures that lie outside each countrys currently observed temperature range. To this end, we impose end-of-century climate on todays European economies following three different greenhouse-gas concentration trajectories, ranging from ambitious climate-change mitigationin line with the Paris agreementto unabated climate change. We find significant increases in average daily peak load and overall electricity consumption in southern and western Europe (similar to 3 to similar to 7% for Portugal and Spain) and significant decreases in northern Europe (similar to-6 to similar to-2% for Sweden and Norway). While the projected effect on European total consumption is nearly zero, the significant polarization and seasonal shifts in peak demand and consumption have important ramifications for the location of costly peak-generating capacity, transmission infrastructure, and the design of energy-efficiency policy and storage capacity.
This study examines the reorganization of formal coordination structures of a unique international public organization involved in marine governance in Europe, namely the structural reorganizations of the International Council for the Exploration of the Sea (ICES) between 1999 and 2009. The findings indicate that the reorganizations of ICES’ formal coordination structures were not driven primarily for reasons of efficiency, by clear and consistent goals, and by clear means-ends considerations for organizational design as proposed by rational perspectives in organization theory. Instead, the formal coordination structures have also been adapted to live up to changing expectations in the institutional environment, to modern management concepts in marine governance such as the Ecosystem Approach to Management (EAM), and to ensure the legitimacy of the organization. However, it is also found that institutional explanations alone are insufficient to comprehensively understand why the formal organizational structures of ICES were reorganized. Instrumental and cultural perspectives in organization theory as well as resource-dependence theory additionally add to understand how ICES responded to external demands and why organizational structures have been changed.
Reform um jeden Preis
(2017)
We prove the hitherto hypothesized sequential dissociation of Fe(CO)(5) in the gas phase upon photoexcitation at 266 nm via a singlet pathway with time-resolved valence and core-level photoelectron spectroscopy with an x-ray free-electron laser. Valence photoelectron spectra are used to identify free CO molecules and to determine the time constants of stepwise dissociation to Fe(CO)(4) within the temporal resolution of the experiment and further to Fe(CO)(3) within 3 ps. Fe 3p core-level photoelectron spectra directly reflect the singlet spin state of the Fe center in Fe(CO)(5), Fe(CO)(4), and Fe(CO)(3) showing that the dissociation exclusively occurs along a singlet pathway without triplet-state contribution. Our results are important for assessing intra- and intermolecular relaxation processes in the photodissociation dynamics of the prototypical Fe(CO)(5) complex in the gas phase and in solution, and they establish time-resolved core-level photoelectron spectroscopy as a powerful tool for determining the multiplicity of transition metals in photochemical reactions of coordination complexes. Published by AIP Publishing.
A particular form of social pain is invalidation. Therefore, this study (a) investigates whether patients with chronic low back pain experience invalidation, (b) if it has an influence on their pain, and (c) explores whether various social sources (e.g. partner and work) influence physical pain differentially. A total of 92 patients completed questionnaires, and for analysis, Pearson’s correlation coefficients and hierarchical linear regression analyses were conducted. They indicated a significant association between discounting and disability due to pain (respective β = .29, p > .05). Especially, discounting by partner was linked to higher disability (β = .28, p > .05).
The nucleophilic thiol-ene (thia-Michael) reaction between molecular rods bearing terminal thiols and bis-maleimides was investigated. The molecular rods have oligospiroketal (OSK) and oligospirothioketal (OSTK) backbones. Contrary to the expectations, cyclic oligomers were always obtained instead of linear rigid-rod polymers. Replacing the OS(T)K rods with a flexible chain yielded polymeric products, suggesting that the OS(T) K structure is responsible for the formation of cyclic products. The reason for the preferred formation of cyclic products is due to the presence of folded conformations, which have already been described for articulated rods.
The unusual mix of morphological traits displayed by extinct South American native ungulates (SANUs) confounded both Charles Darwin, who first discovered them, and Richard Owen, who tried to resolve their relationships. Here we report an almost complete mitochondrial genome for the litoptern Macrauchenia. Our dated phylogenetic tree places Macrauchenia as sister to Perissodactyla, but close to the radiation of major lineages within Laurasiatheria. This position is consistent with a divergence estimate of B66Ma (95% credibility interval, 56.64-77.83 Ma) obtained for the split between Macrauchenia and other Panperissodactyla. Combined with their morphological distinctiveness, this evidence supports the positioning of Litopterna (possibly in company with other SANU groups) as a separate order within Laurasiatheria. We also show that, when using strict criteria, extinct taxa marked by deep divergence times and a lack of close living relatives may still be amenable to palaeogenomic analysis through iterative mapping against more distant relatives.