[DGP Interstitial Lung Disease Patient Questionnaire]. / Patientenfragebogen zur Erfassung der Ursachen interstitieller und seltener Lungenerkrankungen ­ klinische Sektion der DGP.

BACKGROUND: Interstitial lung diseases (ILD) encompass different heterogeneous, mainly chronic diseases of the pulmonary interstitium and/or alveoli with known and unknown reasons. The diagnostic of ILD is challenging and should be performed interdisciplinary. The medical history is of major importance and therefore, in German-speaking countries the Frankfurter Bogen (published in 1985) was utilised to scrutinise the medical history of the patient. This by now more than 30-years-old questionnaire requires a revision with regard to content and language. METHOD: Under the auspices of the clinical section of the DGP the new Interstitial Lung Disease Patient Questionnaire was developed in collaboration amongst pulmonologist, occupational medicine physicians and psychologists and supported by patient support groups. The questionnaire was finally optimised linguistically with the help of patients. RESULTS: The newly developed patient questionnaire for interstitial and rare lung diseases encompasses different domains: initial and current symptoms, medical history questions including prior drug treatments, previous pulmonary and extrapulmonary diseases, potential exposition at home, work and leisure time as well as family history and travelling. CONCLUSION: The newly developed questionnaire can facilitate the diagnosis in patients with suspicion on interstitial lung disease in clinical routine.

Dietary fat and total energy intake modifies the association of genetic profile risk score on obesity: evidence from 48 170 UK Biobank participants.

BACKGROUND: Obesity is a multifactorial condition influenced by both genetics and lifestyle. The aim of this study was to investigate whether the association between a validated genetic profile risk score for obesity (GPRS-obesity) and body mass index (BMI) or waist circumference (WC) was modified by macronutrient intake in a large general population study. METHODS: This study included cross-sectional data from 48 170 white European adults, aged 37-73 years, participating in the UK Biobank. Interactions between GPRS-obesity and macronutrient intake (including total energy, protein, fat, carbohydrate and dietary fibre intake) and its effects on BMI and WC were investigated. RESULTS: The 93-single-nucleotide polymorphism (SNP) GPRS was associated with a higher BMI (ß: 0.57 kg m-2 per s.d. increase in GPRS (95% confidence interval: 0.53-0.60); P=1.9 × 10-183) independent of major confounding factors. There was a significant interaction between GPRS and total fat intake (P(interaction)=0.007). Among high-fat-intake individuals, BMI was higher by 0.60 (0.52, 0.67) kg m-2 per s.d. increase in GPRS-obesity; the change in BMI with GPRS was lower among low-fat-intake individuals (ß: 0.50 (0.44, 0.57) kg m-2). Significant interactions with similar patterns were observed for saturated fat intake (high ß: 0.66 (0.59, 0.73) versus low ß: 0.49 (0.42, 0.55) kg m-2, P(interaction)=2 × 10-4) and for total energy intake (high ß: 0.58 (0.51, 0.64) versus low ß: 0.49 (0.42, 0.56) kg m-2, P(interaction)=0.019), but not for protein intake, carbohydrate intake and fibre intake (P(interaction) >0.05). The findings were broadly similar using WC as the outcome. CONCLUSIONS: These data suggest that the benefits of reducing the intake of fats and total energy intake may be more important in individuals with high genetic risk for obesity.

[Use of the Symptom Validation Test BEVA in Social Medical Assessment]. / Einsatz des Beschwerdenvalidierungstests BEVA in der sozialmedizinischen Begutachtung.

The present study investigates whether the BEVA is suitable to detect negative response bias by claimants with psychosomatic symptoms in the social medical assessment. 107 claimants for disability pension to a psychosomatic disorder fulfilled the BEVA, SIMS and a sociodemographic questionnaire. The social medical examiners assess the credibility of the complaints representation. A Known-Group-Design and a Bootstrapping-Design was used to estimate the validity of the BEVA. For the external criterion SFSS the following psychometric characteristics for the BEVA could be determined: specificity=0.86, sensitivity=0.42, positive predictive value=0.81, negative predictive value=0.51. The interrater reliability estimates with Cohen κ=0.253. If the expert's assessments are chosen as external criterion following psychometric characteristics were estimated: specificity=0.71, sensitivity=0.32, positive predictive value=0.38, negative predictive value=0.66. The rater agreement is Cohen κ=0.031. The results show that the BEVA has an excellent specificity in the detection of negative response bias. This is highly desirable in terms of an ethically moral discussion. Furthermore, the study shows that - in addition to the expert estimates - further screenings can improve the assessment of negative response bias.

[Patient Education Programs in Child and Adolescent Rehabilitation]. / Patientenschulung in der Kinder- und Jugendlichenrehabilitation.

Comprehensive evidence has been provided for the significant increase in most chronic physical illnesses among children and adolescents. Therefore, early diagnosis and multimodal intervention in childhood and adolescence is required to prevent a chronic course of disease. Thus, patient education is essential for the medical child and adolescent rehabilitation. In particular, in developing asthma, atopic dermatitis and obesity training in the past, a basic consensus on the theory and methodology of patient education has emerged. Specifically, in addition to illness-specific modules, generic modules and treatment objectives should be incorporated.

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy - A Review.

In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.

[Evaluation of Contextual Factors in Psychosomatic Rehabilitation]. / Evaluation von Kontextfaktoren in der psychosomatischen Rehabilitation.

Objectives: Although individualized and ICF-oriented implementation of rehabilitation treatment requires knowledge of relevant contextual factors, there is a lack of operationalized documentation and measurement tools to evaluate these factors. Therefore, an ICF-oriented semi-structured interview was designed. Methods: 20 contextual factors were externally assessed whether they negatively affected mental functioning and participation of psychosomatic patients. Additionally, psychometric scales were applied. Results: Six relevant impairing contextual factors were identified. Contextual factors significantly correlated with psychometric scales. Patients with higher contextual impairment showed significantly higher psychological stress levels. Conclusions: Anamnesis of contextual factors at the beginning of psychosomatic rehabilitation yields important information for therapy planning. Further research on contextual factors in medical rehabilitation is needed.

[Cognitive Development in Children with Benign Rolandic Epilepsy of Childhood with Centrotemporal Spikes - Results of a Current Systematic Database Search]. / Kognitive Entwicklung von Kindern mit benigner Epilepsie des Kindesalters mit zentrotemporalen Spitzen (Rolando-Epilepsie) ­ Ergebnisse einer aktuellen systematischen Literaturrecherche.

Benign Rolandic Epilepsy (BRE) is one of the most common epilepsy syndromes in childhood. Although global intellectual performance is typically normal in BRE-patients, problems were found in specific cognitive domains. To summarize recent empirical findings concerning cognitive development in children with BRE a systematic literature search of clinical studies published between 2009 and 2015 was performed. 19 studies of relevance were found.In most recent studies children with BRE consistently showed general intellectual performance within the normal range. However, in two of the studies patients showed a significantly poorer (but still normal) performance in comparison to controls. The studies provide clear indications for a high prevalence of impairments in language (10 out of 12 studies) and academic performance (6 out of 8 studies) in children with BRE. Regarding deficits in other cognitive domains (attention, memory, visual/auditory perception, executive functions) current findings are inconsistent. In addition, no clear results are found in studies examining cognitive development after remission of BRE. Studies on the relationship between selected clinical/electroencephalographic characteristics (e. g. EEG-patterns, focus lateralization) and cognitive performance and studies on potential benefits of anti-epileptic therapy for cognitive functions also have not yielded consistent results. Studies using fMRI and evoked potentials provide evidence for functional reorganization of neural networks in BRE.Due to the developmental risks in children with BRE early cognitive assessment, early treatment and follow-up assessments are important.

[Assessment of Negative Response Bias - Development and Validation of the BEVA]. / Erfassung von negativen Antwortverzerrungen - Entwicklung und Validierung des Beschwerdenvalidierungstests BEVA.

AIM OF THE STUDY: A screening will be developed and validated which measure the negative response bias by inpatients with depressive symptoms. The questionnaire should be appropriate for the claimants for disability pension due to a mental illness. MATERIALS AND METHOD: The present study uses for the construction (K) and validation (V) an analog study design. Healthy participants (depression: K: N=58; V=100; pain: K: N=50; V: N=90) obtained a scenario to feign major depression or pain disorder in the BEVA. In addition, a control group (K: N=78; V: N=89), patients with major depression (K: N=58; V: N=162) and patients with pain disorder (K: N=35; V: N=46) completed the survey about their current mental complaints. RESULTS: Using the data of the construction sample the cut-off values were determined. In the validation sample could be analyzed a sensitivity of 0,75, specificity of 0,95, a positive predictive value of 0,90, and a negative predictive value of 0,86 for the study group "depression". For the pain group had a sensitivity of 0,81, specificity of 0,96, a positive predictive value of 0,97 and a negative predictive value of 0,72 resulted. CONCLUSION: The developed screening has very well values for the validity and reliability. Thus, the method seems suitable to measure negative response bias.

Rsk2, the Kinase Mutated in Coffin-Lowry Syndrome, Controls Cementum Formation.

The ribosomal S6 kinase RSK2 is essential for osteoblast function, and inactivating mutations of RSK2 cause osteopenia in humans with Coffin-Lowry syndrome (CLS). Alveolar bone loss and premature tooth exfoliation are also consistently reported symptoms in CLS patients; however, the pathophysiologic mechanisms are unclear. Therefore, aiming to identify the functional relevance of Rsk2 for tooth development, we analyzed Rsk2-deficient mice. Here, we show that Rsk2 is a critical regulator of cementoblast function. Immunohistochemistry, histology, micro-computed tomography imaging, quantitative backscattered electron imaging, and in vitro assays revealed that Rsk2 is activated in cementoblasts and is necessary for proper acellular cementum formation. Cementum hypoplasia that is observed in Rsk2-deficient mice causes detachment and disorganization of the periodontal ligament and was associated with significant alveolar bone loss with age. Moreover, Rsk2-deficient mice display hypomineralization of cellular cementum with accumulation of nonmineralized cementoid. In agreement, treatment of the cementoblast cell line OCCM-30 with a Rsk inhibitor reduces formation of mineralization nodules and decreases the expression of cementum markers. Western blot analyses based on antibodies against Rsk1, Rsk2, and an activated form of the 2 kinases confirmed that Rsk2 is expressed and activated in differentiating OCCM-30 cells. To discriminate between periodontal bone loss and systemic bone loss, we additionally crossed Rsk2-deficient mice with transgenic mice overexpressing the osteoanabolic transcription factor Fra1. Fra1 overexpression clearly increases systemic bone volume in Rsk2-deficient mice but does not protect from alveolar bone loss. Our results indicate that cell autonomous cementum defects are causing early tooth loss in CLS patients. Moreover, we identify Rsk2 as a nonredundant regulator of cementum homeostasis, alveolar bone maintenance, and periodontal health, with all these features being independent of Rsk2 function in systemic bone formation.

[Influence of Nonverbal Intelligence and Migration Background on Language Abilities]. / Einfluss der nonverbalen Intelligenz und des Migrationshintergrundes auf die sprachlichen Fähigkeiten.

AIM OF THE STUDY: The aim of this study was to investigate the importance of nonverbal intelligence for child language skills. METHODS: 414 children aged between 4 and 5 years were examined regarding their lexical-grammatical skills, their emotion recognition and empathic skill as a basic competence of their pragmatic as well as nonverbal intelligence. Correlations and regression analyses were performed to determine whether the nonverbal IQ contributes to variance explanation in each language area. Additionally, maternal educational level and the migration background were taken into account. RESULTS: Nonverbal intelligence contributed to variance explanation, but to a low degree. A relatively high proportion of variance for the lexical-grammatical skills could be explained by the migration background; contact time with the German language played an essential role here. CONCLUSIONS: The models for lexical-grammatical skills prediction indicate the importance of migration background in relation to the contact time with the German language and nonverbal intelligence. The migration background does not seem to influence emotion recognition competence and empathic skills; nonverbal intelligence represents the only relevant factor.

[The Impact of Visual Perceptual Abilities on the Performance on the Wechsler Nonverbal Scale of Ability (WNV)]. / Der Einfluss von visuellen Wahrnehmungsleistungen auf die Ergebnisse in der Wechsler Nonverbal Scale of Ability (WNV).

BACKGROUND: The use of psychometric tests in with children and adolescents is especially important in psychological diagnostics. Nonverbal intelligence tests are very often used to diagnose psychological abnormalities and generate developmental prognosis independent of the child´s verbal abilities. METHODS: The correlation of the German version of the Developmental Test of Visual Perception - Adolescents and Adults (DTVP-A) with the Wechsler Nonverbal Scala of Abilities (WNV) was calculated based on the results of 172 children, adolescents and young adults aged 9-21 years. Furthermore, it was examined if individuals with poor visual perceptual abilities scored lower on the WNV than healthy subjects. RESULTS: The correlations of the results scored on DTVP-A and WNV ranged from moderate to strong. The group with poor visual perceptual abilities scored significantly lower on the WNV than the control group. CONCLUSIONS: Nonverbal intelligence tests like the WNV are not reliable for estimating the intelligence of individuals with low visual perceptual abilities. Therefore, the intelligence of these subjects should be tested with a test that also contains verbal subtests. If poor visual perceptual abilities are suspected, then they should be tested. The DTVP-A seems to be the right instrument for achieving this goal.

[Language Competence and Behavioural Problems in Preschool]. / Sprachkompetenz und Verhaltensauffälligkeiten im Vorschulalter.

AIM OF THE STUDY: Children with language disorders are at increased risk of developing behavioural and emotional problems. The analysis focused on the question whether behavioural problems differ depending on the type of language deficit. The present study examines the behaviour of preschool children with different language impairments. METHOD: The results of N=540 children aged between 4;0 and 5;11 years were analyzed. Language impairments were classified into phonetics/phonology (n=44), vocabulary (n=44), grammar (n=58), pragmatics (n=26) and multiple language impairments (n=171). In addition, a distinction was made between deficits in language production and comprehension. The children were compared with an unimpaired control group (n=197). The extent of emotional and behavioural problems were analyzed. RESULTS: The results indicate that emotional and behavioural problems differ depending on the type of language deficit already in preschoolers. Especially deficits in language comprehension, pragmatic impairments and multiple language impairments increase the risk of behavioural and emotional problems and hyperactivity. CONCLUSIONS: The relationship between language skills and emotional and behavioural problems should be emphasized in the developmental observation and documentation in preschool. In particular, the distinction between deficits in pragmatics and behavioural problems requires a differentiated examination to ensure an optimal intervention.

[Relationship between Intelligence and Executive Function]. / Zusammenhang zwischen Intelligenz und exekutiven Funktionen.

AIM OF THE STUDY: In this study the correlation between executive functions and intelligence as assessed by the BRIEF-P and WNV, respectively will be examined. METHODS: A sample of 447 children at the 4;0-5;11 year age group was assessed with the WNV. Additionally, parents answered a questionnaire on executive functions (BRIEF-P) and a second questionnaire concerning family background. Partial correlations were calculated on the subtest and scale level and linear regression models were tested. RESULTS: The primary scale Working Memory (BRIEF-P) contributes to an explanation of cognitive functions (WNV), as does the maternal educational level. WM an the Emergent Metacognition Index, which is incorporated the WM scale, shows significant correlation with subtests and with both of the higher order IQ scales of the WNV. CONCLUSION: Already at the preschool age, executive functions play an important role in intelligence. Deficits in EF are related to ADHD and to negative school careers. Early programs for prevention or intervention should be implemented to improve conditions for academic learning.

[Relationship Between General Cognitive Abilities and School Achievement: The Mediation Role of Learning Behavior]. / Zum Zusammenhang von allgemeinen kognitiven Fähigkeiten und schulischer Leistung: Welche Rolle spielt das Lernverhalten?

BACKGROUND: General cognitive abilities are still considered as the most important predictor of school achievement and success. Whether the high correlation (r=0.50) can be explained by other variables has not yet been studied. Learning behavior can be discussed as one factor that influences the relationship between general cognitive abilities and school achievement. METHODS: This study examined the relationship between intelligence, school achievement and learning behavior. Mediator analyses were conducted to check whether learning behavior would mediate the relationship between general cognitive abilities and school grades in mathematics and German. RESULTS: Statistical analyses confirmed that the relationship between general cognitive abilities and school achievement was fully mediated by learning behavior for German, whereas intelligence seemed to be the only predictor for achievement in mathematics. These results could be confirmed by non-parametric bootstrapping procedures. CONCLUSION: RESULTS indicate that special training of learning behavior may have a positive impact on school success, even for children and adolescents with low IQ.

[Common Risk Factors of Depressive and Anxiety Symptomatics in Childhood and Adolescence: A Systematic Review from Transdiagnostic Perspectives]. / Gemeinsame Risikofaktoren von depressiver und ängstlicher Symptomatik im Kindes- und Jugendalter: ein systematisches Review aus transdiagnostischer Perspektive.

Common causes of mental disorders are revealed by transdiagnostic perspectives. In this context, based on the study of Epkins and Heckler, the present study investigates common risk factors in depressive and anxiety symptomatics of children and adolescents. In a systematic literature search between 2012 and 2014, 35 studies were identified which demonstrated 44 common risk factors in internalising symptomatics in childhood and adolescence. Female gender, the onset of puberty, compliance with chronic illness, increased stress experience of children and mothers, negative parenting, misuse or rejective experiences in peers are evident factors in the developmental psychopathology of depression and anxiety disorders in childhood or adolescence. These common risk factors suggest a similar treatment of these diseases.

[How can Instructions and Motivation for a Pension Influence the Response in Questionnaires?]. / Beeinflussen Instruktionen und die Motivation für eine Rente die Beschwerdedarstellung in Fragebogen?

AIMS OF THE STUDY: The study investigates whether the motivation for obtaining a pension together with written instructions change the response bias in symptom scales as well as symptom validity test. MATERIALS AND METHOD: 80 warned and 91 unwarned claimants for disability pension due to a mental illness were recruited. Participants completed a socio-demographic questionnaire (with statements to measure motivation), the module A of the HEALTH-49 as well as the SIMS. RESULTS: ANOVAs (analysis of variance) showed that warned claimants had significantly higher scores in total assets in symptom scales of the HEALTH-49 as well as the SIMS compared to the unwarned claimants. Warned persons showed higher odds for an invalid value in the SIMS. A regression analysis revealed that the item "retirement means for me a chance to be healthy" can predict the criterion total score of the SIMS. CONCLUSION: Warnings may produce negative response bias in symptom scales. Patients made negative response bias when they hope to recover through their pension.

Smoking during Pregnancy Is a Risk Factor for Executive Function Deficits in Preschool-aged Children.

Introduction: Maternal nicotine use during pregnancy has a negative impact on the child. Numerous studies have demonstrated an association between smoking during pregnancy and psychological deficits. This study looks at deficits in executive functioning in preschool-aged children. Methods: The executive functioning of preschool children was assessed by asking parents to complete the parental form of the Behavior Rating Inventory of Executive Functions - Preschool Version (BRIEF-P, German version). The results for preschool children whose mothers had smoked during pregnancy (n = 71) were compared with those of a control group. In a subsample, parental assessments of children of smokers (n = 42) and non-smokers (n = 27) were complemented by the teacher form of the BRIEF-P (German version), which allowed inter-rater agreement (parents vs. preschool teachers) to be assessed. Results: An increased incidence of executive function deficits was noted in the children of smokers, based on parental assessment. Clinically relevant deficits were particularly evident with regard to inhibition, with inhibitory deficits in children of smokers found to be almost four times higher than in the control group (p = 0.006). Inhibitory deficits were reported both by parents and by preschool teachers. Discussion: The increased percentage of executive function deficits described here, particularly the increased inhibitory deficits, confirms the current state of research on smoking during pregnancy. Poor inhibition or impulse control is a key symptom of ADHD.

Family strain and its relation to psychosocial dysfunction in children and adolescents after liver transplantation.

Parental functioning is essential to children's development. Therefore, this cross-sectional single-center study examined the prevalence of family strain in 181 parents and its associations to psychosocial functioning in their children after LT. Median age at LT was one yr. Mean time elapsed since LT was 5.8 yr. The IFS, and the SDQ were applied to parents. Family strain in the present sample was comparable to that in the German normative group of families with a chronically ill or disabled child, but families of LT recipients showed a significantly higher financial impact, impact on coping, and impact on siblings (p < 0.001). Younger age of patients at survey, a more severe clinical course, child's restrictions, and financial losses following LT were determined as significant predictors of family strain (R(2)  = 0.42). Parents reported less family strain after living-related compared with deceased donation. Family strain was significantly correlated to psychosocial dysfunction in children post-LT. Present findings demonstrate a risk of maladjustment to the post-LT condition in families. They emphasize the importance of psychological assessment of parents and patients during transplant and follow-up to ensure the best achievable long-term outcome of patients.