[Epidemiological cancer data online: an overview of information service in Germany and Europe]. / Krebsepidemiologische Daten im Internet : Eine Übersicht über Informationsangebote im nationalen und europäischen Rahmen.

Finding reliable data about cancer epidemiology on the World Wide Web is not an easy task. Information is often scattered, and sources are not always clear. This article gives a short overview of the most important websites that provide reliable data for Germany and Europe. Four internet sites are presented: The German Centre for Cancer Registry Data (ZfKD), the Association of Population-Based Cancer Registries in Germany (GEKID), and two different websites created by the International Agency for Research on Cancer (IARC). In combination, they provide comprehensive information about the distribution of cancer in Germany and Europe.

[The (German) Center for Cancer Registry Data (ZfKD) at the Robert Koch Institute (RKI) in Berlin]. / Das Zentrum für Krebsregisterdaten (ZfKD) im Robert Koch-Institut (RKI) in Berlin.

Cancer represents the second most common cause of death in Germany. The country's federal states operate regional population-based cancer registries that collect and analyze data on cancer patients. This provides an essential basis for describing the cancer burden in the German population. In order to obtain valid and reliable information on cancer incidence at the national level, the Robert Koch Institute (RKI) set up the Federal Cancer Surveillance Unit in 1983 as a central institution for evaluating this cancer registry data. In August 2009, when the Federal Cancer Registry Data Act (BKRG) came into force, the Center for Cancer Registry Data (ZfKD) at the RKI took over the work of the Cancer Surveillance Unit with a broader remit. In the future, it will also regularly publish findings on survival, prevalence, and tumor stage distribution. A newly established record linkage process will help identify multiple submissions from the federal states. Further innovations and new tasks of the ZfKD include expanding an interactive Internet platform and encouraging a more intensive use of cancer registry data for epidemiological research by providing datasets to external scientists. The range of information available to the interested public is also to be expanded.

Stress in 1st-year women teachers: the context of social support and coping.

The effects of adverse work environments were examined in the context of other risk/protective factors in this extension of a short-term longitudinal study involving 184 newly appointed women teachers. Regression analyses revealed that-adjusting for preemployment levels of the outcomes and negative affectivity-social support and adversity in the fall work environment were among the factors that affected spring depressive symptoms, self-esteem, job satisfaction, and motivation to teach. Support from nonwork sources was directly related to future improved symptom levels and self-esteem; supervisor and colleague support were directly related to future job satisfaction. Effects of occupational coping, professional efficacy, locus of control, and school factors (e.g., special vs. regular education) were largely nonsignificant. Structural equation analyses indicated that adverse working conditions began to seriously affect the women soon after they started teaching.

Psychiatric outcomes in low-birth-weight children at age 6 years: relation to neonatal cranial ultrasound abnormalities.

BACKGROUND: This study examined the relation of neonatal cranial ultrasound abnormalities to psychiatric disorder at age 6 years in a regional birth cohort of low-birth-weight children. METHODS: Neonatal cranial ultrasound abnormalities were classified as (1) isolated germinal matrix and/or intraventricular hemorrhage (suggestive of injury to glial precursors) or (2) parenchymal lesions and/or ventricular enlargement (suggestive of white matter injury) with or without germinal matrix-intraventricular hemorrhage. Psychiatric disorders by DSM-III-R at age 6 years were assessed by means of a structured parent interview. Children with severe mental retardation were excluded. Analyses were conducted first in the entire sample and then in children with normal intelligence. RESULTS: Twenty-two percent of the cohort had at least 1 psychiatric disorder, the most common being attention deficit hyperactivity disorder (15.6%). In the entire sample, parenchymal lesions and/or ventricular enlargement increased risk relative to no abnormality, independently of other biological and social predictors, for any disorder (odds ratio [OR], 4.4; 95% confidence interval [CI], 1.8-10.3; P < .001), attention deficit hyperactivity disorder (OR, 3.4; CI, 1.3-8.7; P = .02), and tic disorders (OR, 8.7; CI, 1.3-57.7; P = .02). In children of normal intelligence, parenchymal lesions/ventricular enlargement independently increased risk for any disorder (OR, 4.8; CI, 1.6-12.0; P < .01), attention deficit hyperactivity disorder (OR, 4.5; CI, 1.3-16.0; P = .02), and separation anxiety (OR, 5.3; CI, 1.1-24.8; P = .03). These effects were not ameliorated by female sex or social advantage. Isolated germinal matrix/intraventricular hemorrhage was not related to psychiatric disorder at age 6 years. CONCLUSION: Neonatal cranial ultrasound abnormalities suggestive of white matter injury significantly increased risk for some psychiatric disorders at age 6 years in low-birth-weight children.

Minor physical anomalies: modifiers of environmental risks for psychiatric impairment?

OBJECTIVE: To test the hypothesis that minor physical anomalies (MPAs) modify an adolescent's vulnerability to environmental risk factors for psychopathology. METHOD: One hundred eighteen unreferred male adolescents who had been evaluated as 7-year-olds received a comprehensive neuropsychiatric evaluation. The evaluation included standardized assessments of environmental risk factors for psychiatric impairment, neurological signs, IQ, MPAs, and psychiatric impairment. The relationship between psychiatric status and environmental risk was examined as a function of the MPA profile. RESULTS: There was a significant interaction between MPAs and environmental risk in predicting psychiatric status. Environmental risk was more predictive of psychiatric impairment at age 17 in subjects with high scores on the MPA scale than in subjects with low scores on the scale. This relationship was particularly apparent in subjects with conduct disorder. MPAs also exhibited relationships with two childhood factors, neurological soft signs and Verbal IQ, that had been shown to predict adolescent psychopathology in prior reports on this cohort. CONCLUSIONS: MPAs may contribute to psychiatric impairment by influencing an individual's vulnerability to environmental risk factors for psychopathology. These suggestive findings are consistent with an emerging body of literature examining the role of biopsychosocial interactions in psychiatric disorders.

Relation of negative affectivity to self-reports of job stressors and psychological outcomes.

A total of 250 new women teachers participated in a longitudinal study of the influence of negative affectivity (NA) on the relation of self-report work-environment measures to psychological outcomes. Three "neutrally worded" work-environment measures were specially constructed to minimize confounding with NA. The work-environment measures were moderately related to postemployment depressive symptoms, job satisfaction, and, among Whites but not among a principally Black and Hispanic subsample, motivation. Correlation and regression coefficients were largely unchanged when the preemployment psychophysiologic symptoms scale and the Center for Epidemiologic Studies-Depression Scale (L. S. Radloff, 1977), factors that tap NA, were controlled. Findings suggest NA does not overly distort the relation of some self-report work-environment measures to depressive symptoms, satisfaction, and motivation.

Neonatal cranial ultrasound abnormalities in low birth weight infants: relation to cognitive outcomes at six years of age.

OBJECTIVE: To assess the independent relation of neonatal cranial ultrasound (US) abnormalities in low birth weight (LBW) infants to cognitive outcomes at 6 years of age. DESIGN: Prospective cohort study. SAMPLE AND METHODS: Six-year follow-up data were obtained on a regional birth cohort of LBW infants (< 2 kg) systematically screened as neonates with serial US. US abnormalities were dichotomized into isolated germinal matrix/intraventricular hemorrhage (GM/IVH) and parenchymal lesions/ventricular enlargement (PL/VE). Global cognitive outcomes (mental retardation, borderline intelligence, and normal intelligence) and selected specific cognitive abilities were assessed at 6 years of age with standardized instruments. Multivariate techniques were used to assess the effects of US independent of maternal social disadvantage at birth and other perinatal and neonatal risk factors. RESULTS: The sample as a whole had a significantly elevated rate of mental retardation (MR; 5%), almost all moderate to profound in severity. PL/VE was independently related to MR (odds ratio [OR], 65.8; confidence interval [CI], 19.1 to 22.4) and borderline intelligence (OR, 3.7; CI, 1.3 to 10.8); isolated GM/IVH was more modestly related to MR (OR, 4.6; CI, 1.2 to 18.6) but not related to borderline intelligence. Approximately half of the cases of MR were attributable to PL/VE independent of other factors. Of non-US factors, the number of days receiving mechanical ventilation increased the risk for MR. Maternal social disadvantage increased the risk for borderline intelligence but not MR. Among children of normal intelligence, those with PL/VE, but not isolated GM/IVH, performed more poorly than those without US abnormalities on tests of visual perceptual organization but not on tests of language, memory, or quantitative skills. CONCLUSION: Prevention of white matter injury would substantially improve cognitive outcomes for LBW infants.

Persistent emotional disorder in children with neurological soft signs.

OBJECTIVE: This paper provides clinical details in the form of case vignettes from a prospective epidemiological study that found the combination of childhood "soft" signs and anxious behavior to be a strong risk factor for adolescent emotional disorders. METHOD: The original study conducted a neuropsychiatric assessment of adolescents who had been followed through childhood. RESULTS: The at-risk subjects are shown to exhibit a persistent and specific pattern of both motor abnormalities and anxiety, obsessional compulsive, or depressive symptoms over time. DISCUSSION: The form of their neurological and psychiatric abnormalities is consistent with neuropsychiatric research linking motor system abnormalities to emotional disorders. It is recommended that children who present with anxious and depressive symptoms be examined for motor soft signs.

Dimensions of functional social support and psychological symptoms.

In the summer following graduation a sample of 125 female college graduates (mean age = 28) completed Cohen & Wills' ISEL (1985) which includes scales measuring four social support functions: belonging (social companionship), appraisal (availability of confidants), tangible (instrumental), and self-esteem support. In the summer and fall subject status on two outcome scales was ascertained: the Psychophysiologic Symptom Scale and the Center for Epidemiologic Studies Depression Scale (CES-D). Reliability of the difference scores suggested that the ISEL scales do not measure entirely different constructs and the ISEL Self-esteem Scale is operationally redundant with the Rosenberg Self-esteem scale and the CES-D. Cross-sectional analyses indicated that the ISEL scales were related to symptoms. By contrast, standard longitudinal and prospective MLR analyses indicated that only the Belonging Scale was significantly related to future symptoms. The issues of confounding support with symptoms and the dimensionality of the subscales were discussed. The study suggests that specific functions of support take on greater importance during major life transitions and that any one supportive behaviour often serves multiple functions.

Psychological distress in a sample of teachers.

This article describes a cross-sectional study of the links between job-related stressors and depressive and psychophysiologic symptoms and morale in 67 New York City teachers. The teachers' mean score on the Center for Epidemiologic Studies Depression Scale (CES-D; M = 13.03) was higher than might be expected from average community residents. The teachers also tended to express dissatisfaction with their jobs. The CES-D and the Psychophysiologic Symptom Scale were correlated as highly as their reliabilities would permit, a finding consistent with the view that the CES-D and the Psychophysiologic Symptom Scale measure the same construct, nonspecific psychological distress. The correlational findings suggest that distress is distinct from job-related morale, which was indexed by measures of motivation to continue teaching and job satisfaction. The results of regression analyses, which controlled for sociodemographic factors, indicated that the level of job strain (frequency of ongoing stressors) is more closely related to psychological distress and low morale than episodic stressors, including crimes in which the teacher was victim. The regression analyses also indicated that colleague support was related to lower symptom levels and higher morale.

Neurological soft signs and school achievement: the mediating effects of sustained attention.

A group of 115 black male adolescents drawn from a clinically unselected birth cohort, half of whom were known to have had neurological soft signs at age 7, were examined at age 17 to determine the relation between soft signs and performance on standard tests of school achievement and sustained attention. Three signs measured at age 17--dysgraphesthesia, difficulties with rapid alternating movements (dysdiadochokinesis), and motor slowness--were related to lower concurrent and past IQ and to impaired performance on laboratory and paper-and-pencil measures of sustained attention. The relation between signs and the attentional measures remained significant after IQ was statistically controlled. The three age 17 soft signs as well as age 7 signs were related to impaired performance on standardized tests (age 17) of school achievement. Most of the relation between signs and school achievement could be accounted for by the variance signs shared with sustained attention. One sign, mirror movements, was unrelated to all other attentional and cognitive measures.

Conduct disorder and cognitive functioning: testing three causal hypotheses.

The sample consisted of black adolescents who were members of the Columbia-Presbyterian chapter of the Collaborative Perinatal Project from birth to age 7. At age 17, subjects and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Results from least-squares and logistic regression analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM III. The results suggested that the relation of cognitive functioning to psychiatric status appears to be specific to conduct disorders. The results were incompatible with a "third" variable hypothesis (third factors included neurological status and environmental disadvantage) and the hypothesis that conduct problems lead to deficits in cognitive functioning. The 3 most (and equally) important factors in accounting for age-17 conduct disorder were cognitive functioning, parent psychopathology, and early aggression. A closer look at the data tentatively suggested that a broad deficiency in acculturational learning, rather than narrowly focused social cognitive differences or native endowment, constitutes a key element in the link between cognitive functioning and conduct disorder. Test bias was ruled out as a possible explanation for the results.

Prediction of intellectual deficits in children with acute lymphoblastic leukemia.

Possible predictors of reported lower cognitive functioning in irradiated children with acute lymphoblastic leukemia (ALL) were investigated. Thirty-four subjects, 5-14 years old, with ALL in continuous complete remission and without evidence of current or past central nervous system disease, were examined 9-110 months after diagnosis, using standard measures of intelligence and academic achievement. Subjects with a history of post-irradiation somnolence syndrome were significantly older at diagnosis than nonsomnolent subjects. Intelligence (IQ) was found to be unrelated to history of somnolence syndrome. IQ and achievement were unrelated to age at irradiation, irradiation-examination interval, and radiation dosages. The strongest predictor of IQ by far is parental social class. The importance of controlling for social class differences when searching for treatment effects on IQ and achievement is stressed.

Ten-year consistency in neurological test performance of children without focal neurological deficit.

To assess 'soft-sign' persistence and its correlates outside a referred sample, 159 members of a local birth cohort of the United National Collaborative Perinatal Project were traced and their performance on six neurological test scales was measured at age 17 by examiners blind to their status at age seven. A comparison group was also formed, who had been 'sign-free' at age seven. On four of the six tests (dysdiadochokinesis, mirror movements, dysgraphesthesia and motor slowness) index boys did significantly worse than the comparison boys; by contrast, index girls scored significantly worse than comparisons only on motor slowness.

Neurological soft signs. Their relationship to psychiatric disorder and intelligence in childhood and adolescence.

Sixty-three male and 27 female adolescents known to have had neurological soft signs at the age of 7 years were compared with controls with no soft signs at age 7. Adolescents with early soft signs had significantly lower IQs and were more likely to have a psychiatric disorder characterized by anxiety, withdrawal, and depression. All the girls and 80% (12/15) of the boys with an anxiety-withdrawal diagnosis showed early soft signs. There was no relationship between early soft signs and attention deficit or conduct disorders. Examination of the relative contributions of anxiety at age 7, IQ, and social and family disadvantage to later diagnosis showed that most of the variance was accounted for by soft signs independently of IQ. Soft signs and anxious dependent behavior at age 7 were strongly predictive of persistent psychiatric disorder characterized by anxiety and withdrawal.