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Wiehn J, Kurth T, Ravens-Sieberer U, Prugger C, Piccininni M, Reiss F. Effect of elevated depressive symptoms during adolescence on health-related quality of life in young adulthood-a six-year cohort study with repeated exposure measurements. Front Pediatr 2024; 12:1252964. [PMID: 39055620 PMCID: PMC11269264 DOI: 10.3389/fped.2024.1252964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Objectives Depression is a major contributor of young people's burden of disease. In this study we aim to estimate the effect of elevated depressive symptoms on physical health-related quality of life. Design We used self-reported information from the prospective BELLA cohort study, which included adolescents selected from the general population in Germany. The baseline assessment (2003-2006) and the 1-, 2-, and 6-year follow-up waves provide the data basis. Participants The baseline study population consisted of 1,460 adolescents between the ages of 12 and 17 who, according to their caregivers, did not suffer from depression. Variables The primary outcome, as measured by the physical component score (PCS) of the SF-36 at a 6-year follow-up (range: 0-100), is physical health-related quality of life. The exposure of interest is depressive symptoms, as measured by the Center for Epidemiological Studies Depression Scale for Children (CES-DC) at baseline, 1-year follow-up and 2-year follow-ups (range: 0-60). We dichotomized the exposure into subthreshold (≤15) and elevated depressive symptoms (>15). For the main analyses we considered a cumulative index for elevated depressive symptoms across the three time points (range: 0-3). Considered confounders are sex, age, socioeconomic status, migrant background, social support, anxiety symptoms, physical activity, chronic diseases, and sleeping problems. Statistical methods We used multiple imputation to account for missing values. Within each imputed dataset, we applied inverse probability weighting (IPW) to estimate the effect of the cumulative index for elevated depressive symptoms at baseline, 1- and 2-year follow-up on physical health-related quality of life at 6-year follow-up. We derived 95% confidence intervals by bootstrapping. Results After adjusting with IPW, the effect of the cumulative index per one unit increase of elevated depressive symptoms on the physical component score was -1.71 (95% CI: -3.51 to -0.04). The adjusted effect estimates of single exposure of elevated depressive symptoms on physical health-related quality of life were -0.83 (95% CI: -3.69 to 1.87) at baseline, -2.96 (95% CI: -4.94 to -0.52) at 1-year follow-up and -1.32 (95% CI: -3.85 to 1.15) at 2-year follow-up. Conclusion Findings suggest that elevated depressive symptoms during adolescence decrease physical health-related quality of life in young adulthood.
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Affiliation(s)
- Jascha Wiehn
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christof Prugger
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Marco Piccininni
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Walter LP, Göldel JM, Warschburger P. Originalarbeiten / Original Articles. Die protektive Rolle von Selbstregulation für die gesundheitsbezogene Lebensqualität bei Jugendlichen mit einer chronisch körperlichen Erkrankung / The Protective Role of Self-Regulation for HRQOL of Adolescents with a Chronic Physical Health Condition. Prax Kinderpsychol Kinderpsychiatr 2024; 73:311-330. [PMID: 38840539 DOI: 10.13109/prkk.2024.73.4.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
The Protective Role of Self-Regulation for HRQOL of Adolescents with a Chronic Physical Health Condition A physical chronic condition comes with many challenges and negatively impacts the healthrelated quality of life (HRQOL) of those affected. Self-regulation plays an important role in successfully coping with the demands of a chronic condition. In line with a resource-oriented approach, this study aimed to investigate themoderating effect of self-regulation on the relationship between disease severity andHRQOL. For this, 498 adolescents with cystic fibrosis, juvenile idiopathic arthritis, or type-1 diabetes aged of 12-21 years (M= 15.43, SD= 2.07) were recruited through three patient registers. Subjective disease severity, self-regulation (Brief Self-Control- Scale), andHRQOL (DISABKIDSChronicGenericMeasure)were examined at two time points (T₁ and T₂, one year apart). Cross-sectional analysis showed significant effects of subjective disease severity and self-regulation on HRQOL. Prospective analysis, in which HRQOL at T₁ was controlled for, revealed that disease severity only predicted emotion-related HRQOL at T₂; selfregulation emerged as a predictor for HRQOL subscales independence, emotion, inclusion, exclusion, and treatment. A significantmoderation effect of self-regulation was found on the relationship between disease severity and HRQOL emotion. Our results highlight the positive impact of self-regulation on quality of life, specifically in the context of chronic conditions and represent a starting point for prevention and intervention approaches.
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Ciorba MC, Maegele M. Polytrauma in Children. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:291-297. [PMID: 38471125 DOI: 10.3238/arztebl.m2024.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Inadequate clinical experience still causes uncertainty in the acute diagnostic evaluation and treatment of polytrauma in children (with or without coagulopathy). This review deals with the main aspects of the acute care of severely injured children in the light of current guidelines and other relevant literature, in particular airway control, volume and coagulation management, acute diagnostic imaging, and blood coagulation studies in the shock room. METHODS This review is based on literature retrieved by a selective search in PubMed, Medline (OVIDSP), the Cochrane Central Register of Controlled Trials, and Epistemonikos covering the period January 2001 to August 2023. Review articles and the updated S2k clinical practice guideline on polytrauma management in childhood were considered. RESULTS Most accidents in childhood occur at home and in the child's free time, with varying mechanisms and patterns of injury depending on age. The outcome of treatment depends largely on the presence or absence or traumatic brain injury, which affects 66% of children with polytrauma and is thus the most common type of injury in this group, and of hemorrhagic shock with or without coagulopathy. Acute care follows the ABCDE algorithms with attention to special features in children, including age-specific reference values. According to a registry study, coagulopathy and hypovolemic shock are associated with 22% and 17% mortality, respec - tively. Treatment in a pediatric trauma reference center of the trauma network is recommended. Computed tomography (CT) should be carried out in children in accordance with defined criteria (PECARN), as a team decision and with the use of age-specific low-dose CT protocols. In children as in adults, viscoelasticity-based point-of-care tests enable the prompt diagnosis of relevant coagulopathies and their treatment in consideration of age-specific target values. The administration of tranexamic acid remains controversial. CONCLUSION 4% of polytrauma patients are children. Because children differ from adults both anatomically and physiologically, the diagnostic evaluation and management of polytrauma in children presents a special challenge. The evidence base for pediatric polytrauma management is still inadequate; current recommendations are based on consensus, in consideration of the special features of children compared to adults.
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Affiliation(s)
- Monica Christine Ciorba
- Department of Orthopedics, Trauma Surgery and Sports Traumatology, Cologne-Merheim Medical Center, University of Witten/Herdecke, Cologne, Germany; Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne-Merheim Campus, Cologne, Germany
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Neuperdt L, Beyer AK, Junker S, Mauz E, Hölling H, Schlack R. [Parental strain, inattention/hyperactivity symptoms and parent-reported ADHD in children and adolescents: results of the KiGGS study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:429-438. [PMID: 38536438 PMCID: PMC10995013 DOI: 10.1007/s00103-024-03859-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND A child's attention deficit hyperactivity disorder (ADHD) is associated with strain for the parents. In turn, psychosocial parental strain is associated with higher probabilities for the occurrence of inattention/hyperactivity symptoms (IHS) in their children. The aim of this paper is to assess the association between parental strain, IHS, and a parent-reported ADHD diagnosis of the children. METHODOLOGY Based on data from n = 4596 participants of the KiGGS cohort (wave 2: 2014-2017), the type and extent of parental strain was set in relation to IHS and an ADHD diagnosis of the child in cross-sectional analysis. Frequencies, means, beta coefficients, and odds ratios adjusted for sex, age, socioeconomic status, and migration background are reported. RESULTS In individual consideration, a greater number of parental strains were associated with IHS than with an ADHD diagnosis. In a multivariate analysis, financial worries and parenting problems/conflicts with the children were significant predictors of IHS and an ADHD diagnosis, respectively. In addition, four or more types of parental strain were associated with a higher likelihood of both IHS and an ADHD diagnosis. DISCUSSION Financial and child-rearing strain are relevant to parents of children with IHS and an ADHD diagnosis. Interrelationships between parental stress and a child's IHS or an ADHD diagnosis can be assumed. To relieve their burden, prevention can either aim at improving the situation of ADHD-affected families or at improving the family's handling of the child's ADHD.
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Affiliation(s)
- Laura Neuperdt
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Ann-Kristin Beyer
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Stephan Junker
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Elvira Mauz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Heike Hölling
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Robert Schlack
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
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Hirtz R, Grasemann C, Hölling H, von Holt BH, Albers N, Hinney A, Hebebrand J, Peters T. No relationship between male pubertal timing and depression - new insights from epidemiology and Mendelian randomization. Psychol Med 2024:1-10. [PMID: 38515277 DOI: 10.1017/s0033291724000060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND In males, the relationship between pubertal timing and depression is understudied and less consistent than in females, likely for reasons of unmeasured confounding. To clarify this relationship, a combined epidemiological and genetic approach was chosen to exploit the methodological advantages of both approaches. METHODS Data from 2026 males from a nationwide, representative study were used to investigate the non-/linear relationship between pubertal timing defined by the age at voice break and depression, considering a multitude of potential confounders and their interactions with pubertal timing. This analysis was complemented by Mendelian randomization (MR), which is robust to inferential problems inherent to epidemiological studies. We used 71 single nucleotide polymorphisms related to pubertal timing in males as instrumental variable to clarify its causal relationship with depression based on data from 807 553 individuals (246 363 cases and 561 190 controls) by univariable and multivariable MR, including BMI as pleiotropic phenotype. RESULTS Univariable MR indicated a causal effect of pubertal timing on depression risk (inverse-variance weighted: OR 0.93, 95%-CI [0.87-0.99)], p = 0.03). However, this was not confirmed by multivariable MR (inverse-variance weighted: OR 0.95, 95%-CI [0.88-1.02)], p = 0.13), consistent with the epidemiological approach (OR 1.01, 95%-CI [0.81-1.26], p = 0.93). Instead, the multivariable MR study indicated a causal relationship of BMI with depression by two of three methods. CONCLUSIONS Pubertal timing is not related to MDD risk in males.
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Affiliation(s)
- Raphael Hirtz
- Department of Pediatrics, Division of Rare Diseases, and CeSER, Ruhr-University Bochum, Alexandrinenstr. 5, 44791 Bochum, Germany
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 40211 Essen, Germany
- Helios University Medical Centre Wuppertal - Children's Hospital, Witten/Herdecke University, Wuppertal, Germany
| | - Corinna Grasemann
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 40211 Essen, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Björn-Hergen von Holt
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein, 23562 Lübeck, Germany
| | - Nicola Albers
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Winter K, Moor I, Markert J, Bilz L, Bucksch J, Dadaczynski K, Fischer SM, Helmchen RM, Kaman A, Möckel J, Rathmann K, Ravens-Sieberer U, Reiß F, Schierl T, Schütz R, Sendatzki S, Stürmer E, Sudeck G, Richter M. Concept and methodology of the Health Behaviour in School-aged Children (HBSC) study - Insights into the current 2022 survey and trends in Germany. JOURNAL OF HEALTH MONITORING 2024; 9:99-117. [PMID: 38559683 PMCID: PMC10977469 DOI: 10.25646/11878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/28/2023] [Indexed: 04/04/2024]
Abstract
Background Health Behaviour in School-aged Children (HBSC) is one of the largest international studies on child and adolescent health and cooperates with the World Health Organization (WHO). In Germany, adolescents aged 11, 13 and 15 are surveyed every four years about their health, health behaviour and social conditions. This article describes the HBSC study and in particular the methodology of the current 2022 survey and prior surveys conducted between 2009/10 and 2017/18. Method 174 schools with a total of 6,475 students participated in the 2022 survey. The survey was conducted using questionnaires and covered a wide range of topics (including mental health, physical activity, bullying experiences, social determinants of health and experiences related to COVID-19). The 2022 survey was complemented by a school principal survey (N = 160). In addition to the current sample, the samples of the three previous surveys with representative data for Germany are presented: 2009/10 (N = 5,005), 2013/14 (N = 5,961) and 2017/18 (N = 4,347). Discussion The health of children and adolescents is of great public health importance. The HBSC study makes a substantial contribution by providing internationally comparable results, analysing trends, and providing stakeholders with comprehensive and representative health monitoring data.
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Affiliation(s)
- Kristina Winter
- Martin Luther University Halle-Wittenberg, Halle (Saale)
- Hochschule Nordhausen – University of Applied Sciences
| | - Irene Moor
- Martin Luther University Halle-Wittenberg, Halle (Saale)
| | - Jenny Markert
- Martin Luther University Halle-Wittenberg, Halle (Saale)
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg
| | | | - Kevin Dadaczynski
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
- Leuphana University Lueneburg
| | | | - Ronja M. Helmchen
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf
| | | | - Katharina Rathmann
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
| | | | | | | | - Raphael Schütz
- Brandenburg University of Technology Cottbus-Senftenberg
| | - Saskia Sendatzki
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
| | | | - Gorden Sudeck
- University of Tübingen, Institute of Sports Science
- University of Tübingen, Interfaculty Research Institute for Sports and Physical Activity
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Kleinschlömer P, Kühn M, Bister L, Vogt TC, Krapf S. Analyzing the Impact of Family Structure Changes on Children's Stress Levels Using a Stress Biomarker. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465231223953. [PMID: 38339813 DOI: 10.1177/00221465231223953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Changes in family structure (e.g., parental separation or stepfamily formation) are associated with a deterioration in children's well-being. Most researchers have focused on the impact of such changes on children's educational and psychosocial outcomes, whereas the effects on children's biological processes have been studied less often. We analyze the effects of changes in family structure on children's stress levels using data from the German Health Interview and Examination Survey for Children and Adolescents study (2003-2006 and 2014-2017). Our outcome variable is the biomarker c-reactive protein (CRP), which correlates with psychological distress and is collected from blood samples. Calculating first-difference estimators, we analyze whether children have higher CRP levels after changing to (1) single-parent families (n = 117) or (2) stepfamilies (n = 80). Our findings suggest that changing to a single-parent family significantly increases children's stress, whereas changing to a stepfamily does not. These observations are important because increased stress in childhood can negatively affect well-being later in life.
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Affiliation(s)
| | - Mine Kühn
- Department of Sociology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Lara Bister
- University of Groningen, Groningen, Netherlands
| | | | - Sandra Krapf
- State Institute for Family Research (IFB) at the University of Bamberg, Bamberg, Bayern, Germany
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Büschges JC, Schmidt-Trucksäss A, Neuhauser H. Association of blood pressure and heart rate with carotid markers of vascular remodeling in the young: a case for early prevention. J Hypertens 2024; 42:153-160. [PMID: 37796164 DOI: 10.1097/hjh.0000000000003578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE The association of childhood blood pressure (BP) and heart rate (HR) with intermediate markers of cardiovascular disease several decades later has been shown, but studies on more short-term outcomes are scarce. Using population-based data, this study investigates the association of four BP parameters and HR in childhood with three carotid markers for vascular remodeling one decade later. METHODS At the 11-year follow-up, 4607 participants of the nationwide KiGGS cohort aged 14 to 28 years had semi-automated sonographic carotid intima media thickness (CIMT) measurements. We investigated associations of baseline (age 3-17 years) and follow-up SBP, DBP, mean arterial pressure (MAP), pulse pressure (PP) and resting heart rate (RHR), with CIMT and lumen diameter at or above the 90th percentile and distensibility coefficient at or below the tenth percentile in logistic regressions. Analyses were further adjusted using a composite cardiovascular risk (CVR) score of BMI, triglycerides, total/HDL-cholesterol-ratio and HbA1c. RESULTS SBP, DBP, MAP and RHR were significantly and similarly associated with all carotid measures 11 years later, for example an odds ratio (OR) of 1.17 [confidence interval (CI) 1.06-1.29] for one standard deviation SBP increase with elevated CIMT when adjusting for sex, age and CVR score. Cross-sectionally, the strongest association was found for MAP with reduced distensibility coefficient (OR 1.76; CI 1.59-1.94). CONCLUSION This population-based cohort study shows robust and consistent associations between childhood BP and RHR and three carotid measures of vascular remodeling only one decade later, clearly underscoring the potential importance of preventing high BP already early in the life course.
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Affiliation(s)
- Julia C Büschges
- Robert Koch Institute, Department of Epidemiology and Health Monitoring
- DZHK (German Centre for Cardiovascular Research), partner site Berlin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Hannelore Neuhauser
- Robert Koch Institute, Department of Epidemiology and Health Monitoring
- DZHK (German Centre for Cardiovascular Research), partner site Berlin
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Königstein K, Büschges JC, Schmidt-Trucksäss A, Neuhauser H. Cardiovascular Risk in Childhood is Associated With Carotid Intima-Media Thickness and Stiffness in Adolescents and Young Adults: The KiGGS Cohort. J Adolesc Health 2024; 74:123-129. [PMID: 37815767 DOI: 10.1016/j.jadohealth.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/03/2023] [Accepted: 08/18/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Cardiovascular risk factors are widespread among children and adolescents and may lead to accelerated vascular aging in middle adulthood. However, data are scarce on shorter-term consequences, for example, on associated distinctive vascular properties before age 30 years. This study analyzes the association of childhood exposure to cardiovascular risk factors with carotid properties in adolescents and young adults. METHODS Four thousand thirty one participants from the population-based German Health Interview and Examination Survey for Children and Adolescents cohort (aged 3-17 years) had carotid intima-media thickness (CIMT) and distensibility coefficient (DC) measurements at the second follow-up (aged 14-28 years). The assessment of cardiovascular risk factors at baseline included information about arterial hypertension, obesity, dyslipidemia, and passive smoking. RESULTS Single risk factors and the exposure to multiple cardiovascular risk factors were associated with elevated CIMT and decreased DC. Relative risks for CIMT ≥ 90th centile and/or DC ≤ 10th centile were increased in participants exposed to two (RRCIMT = 1.45 [95% confidence interval 1.11-1.91], p < .05; RRDC = 1.37 [1.02-1.84], p < .05) and ≥ three risk factors (RRCIMT = 1.66 [1.05-2.62], p < .05; RRDC = 1.25 [0.71-2.21], p > .05). DISCUSSION Exposure to multiple cardiovascular risk factors starting in childhood is associated with measurably increased CIMT and carotid stiffness in late adolescence and early adulthood. These findings underline the importance of population-wide preventive measures to promote optimal cardiovascular health.
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Affiliation(s)
- Karsten Königstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany.
| | - Julia Charlotte Büschges
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland; Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
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Krause L, Poulain T, Kiess W, Vogel M. Body image and behavioural and emotional difficulties in German children and adolescents. BMC Pediatr 2023; 23:594. [PMID: 37996808 PMCID: PMC10666319 DOI: 10.1186/s12887-023-04405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Behavioural and emotional difficulties might play an important role in the development of body image disturbances, which represent serious risk factors for eating disorders or depression. The present study provides a detailed overview on body image disturbances and several behavioural and emotional difficulties (differences between gender, age, and weight status) and their inter-relations in German children and adolescents. METHODS Data on body image disturbances, assessed through a Figure Rating Scale, and on behavioural and emotional difficulties, assessed through Goodman's Strengths and Difficulties Questionnaire (SDQ), were available for 5255 observations of 1982 German children and adolescents aged 8 to 18 years from the LIFE Child study, based in Leipzig, Germany. Associations were investigated using multiple logistic regression. Each association was checked for interaction with gender, age, and weight status. RESULTS Boys reported more behavioural difficulties than girls, while girls reported more emotional difficulties. Gender, age and weight status were related to behavioural and emotional difficulties as well as body image disturbances. Individuals with fewer difficulties were more satisfied with their own body. Children and adolescents who desired to be larger showed more prosocial behaviour problems, conduct and emotional problems and more signs of hyperactivity. Those, who desired to be thinner showed more problems in all SDQ-subscales. A more accurate body size perception was associated with fewer behavioural and emotional difficulties. Children and adolescents who overestimated their body size showed more prosocial behaviour and emotional problems. Underestimation one's body size was associated with more signs of hyperactivity. CONCLUSION The current findings highlight the importance of raising the awareness about the association between behavioural and emotional difficulties and body image disturbances in children and adolescents to prevent negative outcomes.
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Affiliation(s)
- Lea Krause
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany.
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany.
| | - Tanja Poulain
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Wieland Kiess
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Mandy Vogel
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
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11
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Zhou Y, Wengler A, Doblhammer G. Association between the starting age of non-parental Early Childhood Education and Care (ECEC), and psycho-social problems in adolescence in West and East Germany - a natural experiment using data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). BMC Psychol 2023; 11:403. [PMID: 37986110 PMCID: PMC10658975 DOI: 10.1186/s40359-023-01447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The study aimed to investigate the association between the start age of non-parental Early Childhood Education and Care (ECEC) and psycho-social problems in adolescence. The similarities and differences between West and East Germany were also investigated in a natural experiment. METHODS Our sample consisted of 1022 children (621 from West Germany, 401 from East Germany) aged 3-4 years at wave 2003-2006 that were followed up to wave 2014-2017 as adolescents (mean ± SD age = 14.4 ± 0.03 years) in the KiGGS study. The psycho-social problems were measured by the parent-reported Strengths and Difficulties Questionnaire (SDQ) at wave 2014-2017. Linear regression was used to explore the relationship between ECEC-start-age and psycho-social problems in adolescence in Germany, and stratified by West and East Germany. RESULTS Those who started ECEC between 2 and 3 years old (reference) had the lowest scores of psycho-social problems in the whole Germany and in West Germany in adolescence. In comparison, those who started ECEC older than 3 years old had higher scores of internalizing psycho-social problems in both West Germany (with statistically significant results) and East Germany (with a relatively larger effect size but insignificant results). Those who started ECEC younger than 1 year old had statistically significant higher scores for externalizing psycho-social problems in West Germany, even though less children started ECEC younger than 1 in West Germany compared to East Germany. This significant association was not found in East Germany. Those who started ECEC between 1 and 2 years old tended to have higher scores of externalizing psycho-social problems in both West and East Germany. CONCLUSION The results suggest that if children start ECEC older than 3 years or younger than 2 years, more attention needs to be given to internalizing or externalizing psycho-social problems respectively. The regional differences for children younger than 1 year old may suggest a selection effect in West Germany where only fewer parents bring babies to ECEC, while the regional similarities for children over 3 years old indicate the importance of providing access to ECEC for children over 3 years old.
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Affiliation(s)
- Ying Zhou
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Gabriele Doblhammer
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany.
- German Center for Neurodegenerative Disease, Bonn, Germany.
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12
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Kordonouri O, Arens S, Lange K, Christoph J, Marquardt E, Danne TPA. Direct LDL-C estimation in preschoolers: Practicable first step for FH screening. J Clin Lipidol 2023; 17:255-260. [PMID: 36858936 DOI: 10.1016/j.jacl.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Individuals with FH develop cardiovascular disease due to lifelong cumulative exposure to elevated LDL-C. Effective screening for FH is not yet established. OBJECTIVE To evaluate the practicability of a FH screening by measuring directly the LDL-C in preschoolers. METHODS LDL-C measurement through capillary blood sampling during the compulsory routine check-ups by the pediatrician in children aged 2 to 6 years including information on family history as dyslipidemia and/or premature cardiovascular disease in first and second grade of pedigrees. RESULTS 15,009 children (52.2% males, median age 3.9 years [IQR 3.0-5.1]) participated in the study. Positive family history for hyperlipidemia was stated in 40.9% cases, in 12.0% also in at least one 1st degree relative. In the total cohort, median LDL-C was 93 mg/dL [IQR 79-109 mg/dL]. Boys had significantly higher LDL-C levels than girls (p < 0.0001), whereas there was no difference regarding their age (p = 0.757). Children from families with a positive history for hypercholesterolemia/dyslipidemia had significantly higher LDL-C levels (p < 0.001) and were more frequently among those with LDL-C values above 135 mg/dL (3.5 mmol/L, 96th percentile; 53.2% vs. 40.3%, p < 0.001) and those with LDL-C levels above 160 mg/dL (4.1 mmol/L, 99th percentile; 45.3% vs. 40.7%, p < 0.001) than children without positive family history. CONCLUSIONS Direct measurement of LDL-C levels in children at ages 2-6 years during the compulsory routine check-ups as well as at any voluntary visits to the pediatrician's office is practicable and delivers reliable information, which can be used for a FH screening strategy in the general population.
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Affiliation(s)
| | - Stefan Arens
- Children's Hospital AUF DER BULT, Hannover, Germany
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Hannover, Germany
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13
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The Challenge of Incomplete Data in Accelerometer Studies: Characteristics of Nonparticipation and Noncompliance in a Nationwide Sample of Adolescents and Young Adults in Germany. J Phys Act Health 2023; 20:226-238. [PMID: 36724792 DOI: 10.1123/jpah.2022-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/26/2022] [Accepted: 12/03/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Incomplete data due to nonparticipation and noncompliance with the study protocol can bias the results of studies. We investigated how a nationwide accelerometer sample of adolescents and young adults is affected by such incomplete data. METHODS We analyzed cross-sectional data from 6465 participants (11-31 y old) who participated in a national health survey in Germany (KiGGS Wave 2; 2014-2017). The data included information about the participation in the measurement of physical activity using accelerometers, compliance with the wear-time protocol, and sociodemographic and health-related variables. Multivariable regression analyses were conducted to detect factors associated with incomplete data. RESULTS Of the total sample, 78.0% participated in the accelerometer part of the study, and 83.5% of the participants with data available complied with the wear-time protocol. In 11- to 17-year-olds, the likelihood of having incomplete accelerometer data was higher in boys, older adolescents, adolescents with a lower sociodemographic status, adolescents with overweight, adolescents not participating in organized sport, adolescents not speaking only German at home, current smokers, and adolescents having a higher soft drink consumption. In 18- to 31-year-olds, the likelihood of having incomplete accelerometer data was higher in men, adults with a lower educational level, adults not speaking only German at home, and adults who smoke. CONCLUSIONS Our results suggest that accelerometer samples are biased such that participants with more beneficial health behaviors provide complete accelerometer data more often. This knowledge should be used to design effective recruitment strategies and should be considered when interpreting results of accelerometer studies.
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14
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Förster LJ, Vogel M, Stein R, Hilbert A, Breinker JL, Böttcher M, Kiess W, Poulain T. Mental health in children and adolescents with overweight or obesity. BMC Public Health 2023; 23:135. [PMID: 36658514 PMCID: PMC9849834 DOI: 10.1186/s12889-023-15032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Overweight and obesity represent huge concerns for children's physical and mental well-being. This study examined the relationship between body mass index (BMI) and health-related quality of life (HRQoL), somatoform complaints, and behavioral problems in children and adolescents. Additionally, the influence of sex, age, and socioeconomic status (SES) on these associations was considered. METHODS In total, we studied 2350 participants between the ages of 4 and 18 years (1213 4- to 10-years-old (child sample) and 1137 11-to 18-year-olds (adolescent sample)). To assess HRQoL, somatoform complaints, and behavioral difficulties, we applied the KIDSCREEN-27, a short form of the Giessen Complaints Questionnaire, and the Strengths and Difficulties Questionnaire (SDQ). The BMI was transformed to BMI standard deviation scores (BMI-SDS), according to German gender- and age-specific reference data. Associations were investigated using linear regression analyses. Each association was checked for interaction with sex, age, and SES. RESULTS Regarding HRQoL, we found worsening scores in physical well-being and psychological well-being with increasing BMI-SDS. Somatoform complaints were not significantly associated with BMI-SDS. Conduct problems, peer relationship problems, and emotional problems (the latter only in the adolescent sample) were positively associated with BMI-SDS. While we did not observe any significant interactions with sex, we found some significant interactions with age and/or SES. CONCLUSION Our findings highlight the importance of mental difficulties in children and adolescents with higher BMI and, consequently, underline the relevance of including psychological interventions in the treatment of overweight or obesity.
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Affiliation(s)
- Lucas-Johann Förster
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany. .,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Mandy Vogel
- grid.9647.c0000 0004 7669 9786LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Robert Stein
- grid.9647.c0000 0004 7669 9786Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany ,grid.411339.d0000 0000 8517 9062Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Anja Hilbert
- grid.9647.c0000 0004 7669 9786Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany
| | - Julius Lars Breinker
- grid.9647.c0000 0004 7669 9786Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany
| | - Marleen Böttcher
- grid.9647.c0000 0004 7669 9786Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- grid.9647.c0000 0004 7669 9786LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Tanja Poulain
- grid.9647.c0000 0004 7669 9786LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
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15
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Hirtz R, Libuda L, Hinney A, Föcker M, Bühlmeier J, Holterhus PM, Kulle A, Kiewert C, Kuhnert R, Cohrdes C, Peters T, Hebebrand J, Grasemann C. Age at menarche relates to depression in adolescent girls: Comparing a clinical sample to the general pediatric population. J Affect Disord 2022; 318:103-112. [PMID: 36058357 DOI: 10.1016/j.jad.2022.08.092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT The timing of puberty, physical features of pubertal development, and hormones are closely intertwined but may also individually contribute to the risk for depression and depression severity. Additionally, their effects on mood may depend on depression severity, but previously this has only been studied in mostly subclinical depression. METHODS In 184 girls from a single psychiatric hospital with significant depressive symptoms (Beck Depression Inventory-II score > 13), the relationship between depression severity and age at menarche (AAM), pubertal status, and gonadal/adrenal hormones (estradiol, progesterone, DHEA-S, androstenedione, testosterone, dihydrotestosterone) was investigated. Moreover, AAM in depressed girls was compared to that from a representative sample of German adolescents without a psychiatric disorder (N = 1674). Androgen levels were compared to those of age- and sex-matched controls (N = 59). RESULTS AAM but not pubertal stage or biochemical parameters related to depression. Girls with AAM at the lower normative range of pubertal development were 61 % more likely to develop depression and scored 4.9 points higher on the depression scale than girls experiencing menarche at the population average. Androstenedione levels were increased in the psychiatric sample, but neither androgen nor gonadal hormone levels were associated with depression severity. LIMITATIONS The study is cross-sectional. CONCLUSIONS These observations confirm previous studies in mostly subclinical depression and highlight the importance of AAM for adolescent depression. Thus, AAM could be considered a prognostic factor for a clinical risk score assessing the probability of adolescent depression. Moreover, these findings suggest fostering efforts that address risk factors that contribute to an earlier AAM.
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Affiliation(s)
- Raphael Hirtz
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 40211 Essen, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr 21, 40211 Essen, Germany.
| | - Lars Libuda
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warbuger Str. 100, 33098 Paderborn, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr 21, 40211 Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Schmeddingstr 50, 48149 Münster, Germany
| | - Judith Bühlmeier
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr 21, 40211 Essen, Germany
| | - Paul-Martin Holterhus
- Department of Pediatrics I, Pediatric Endocrinology and Diabetes, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel, and Christian-Albrechts University, Arnold-Heller-Str. 3, 24105 Kiel, Germany
| | - Alexandra Kulle
- Department of Pediatrics I, Pediatric Endocrinology and Diabetes, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel, and Christian-Albrechts University, Arnold-Heller-Str. 3, 24105 Kiel, Germany
| | - Cordula Kiewert
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 40211 Essen, Germany
| | - Ronny Kuhnert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany, General-Pape-Str. 62-66, 12101 Berlin
| | - Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany, General-Pape-Str. 62-66, 12101 Berlin
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr 21, 40211 Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr 21, 40211 Essen, Germany
| | - Corinna Grasemann
- Department of Pediatrics, Division of Rare Diseases and CeSER, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstr 5, 44791 Bochum, Germany
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16
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Fritsch J, Weyland S, Feil K, Burchartz A, Schmidt S, Woll A, Strauch U, Wienke B, Jekauc D. A Study on the Psychometric Properties of the Short Version of the Physical Activity Enjoyment Scale in an Adult Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15294. [PMID: 36430013 PMCID: PMC9692518 DOI: 10.3390/ijerph192215294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
A new measure of the short form of the Physical Activity Enjoyment Scale (PACES-S), including four items, has been developed that focuses on the subjective experience of enjoyment. As validation has so far only been conducted in a youth population, the purpose of the present article was to test the psychometric properties of the measure in an adult population in three studies. In the first study (n = 1017) the results supported the unidimensional structure of the instrument (χ2 = 10.0; df = 2; p < 0.01; CFI = 0.992; RMSEA = 0.063), revealed a satisfactory level of internal consistency (ω = 0.79), and showed that the measure is invariant across gender. The results on factorial validity and internal consistency were generally supported by the second study (n = 482), which additionally showed satisfactory test-retest reliability (r = 0.73). Finally, the third study (n = 1336) also supported the factorial validity and internal consistency of the measure and additionally showed a positive correlation with physical activity (r = 0.40), thus supporting the criterion-related validity of the measure. This more economical version of PACES seems to be particularly useful for large-scale studies.
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Affiliation(s)
- Julian Fritsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Susanne Weyland
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Katharina Feil
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Steffen Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Ulrich Strauch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Benjamin Wienke
- Department of Sport and Exercise Psychology, Humboldt University of Berlin, 10117 Berlin, Germany
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
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Falkenstein L, Eckel N, Kadel SB, Koenig J, Litaker D, Eichinger M. Service provision and utilisation in German paediatric primary care practices during public health crises: Protocol of the mixed-methods COVID-19 PedCare Study. BMJ Open 2022; 12:e054054. [PMID: 36220317 PMCID: PMC9556743 DOI: 10.1136/bmjopen-2021-054054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/25/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Public health crises such as pandemics can cause serious disruptions to the utilisation and provision of healthcare services with negative effects on morbidity and mortality. Despite the important role of paediatric primary care in maintaining high-quality healthcare services during crises, evidence about service utilisation and provision remains limited especially in Germany. This study, therefore, explores the utilisation and provision of paediatric primary care services during the ongoing COVID-19 pandemic and their barriers and facilitators. METHODS AND ANALYSIS The study uses a convergent mixed-methods design and comprises online surveys to parents, adolescents and primary care paediatricians (PCPs) and semistructured interviews with parents and PCPs. We recruit parents and adolescents from paediatric primary care practices and PCPs via email using mailing lists of the German Professional Association of Paediatricians and the German Society of Ambulatory Primary Care Paediatrics. The parent and adolescent surveys assess, inter alia, the utilisation of paediatric primary care services and its correlates, aspects of parental and child health as well as socioeconomic characteristics. The PCP survey investigates the provision of paediatric primary care services and its correlates, aspects of PCP health as well as sociodemographic and practice characteristics. The semistructured interviews with parents and PCPs explore several aspects of the online surveys in more detail. We use descriptive statistics and generalised linear mixed models to assess service utilisation and provision and specific correlates covered in the online surveys and apply qualitative content analysis to explore barriers and facilitators of service utilisation and provision more broadly in the semistructured interviews. We will integrate findings from the quantitative and qualitative analyses at the interpretation stage. ETHICS AND DISSEMINATION The study was approved by the Medical Ethics Review Board of the Medical Faculty Mannheim at Heidelberg University (2020-650N). Study results will be published in journals with external peer-review.
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Affiliation(s)
- Lina Falkenstein
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Nathalie Eckel
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Simone B Kadel
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Jochem Koenig
- Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Pediatric Epidemiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - David Litaker
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Michael Eichinger
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Pediatric Epidemiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
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Hirtz R, Hölling H, Grasemann C. Subclinical Hypothyroidism and Incident Depression in Adolescents and Young Adults: Results from a Nationwide Representative Prospective Study. Thyroid 2022; 32:1169-1177. [PMID: 35946076 DOI: 10.1089/thy.2022.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Although the relationship between subclinical hypothyroidism and major depressive disorder (MDD) has been studied in adults in cross-sectional and prospective population-based studies, this has not yet been done in adolescents. However, since thyroid function and MDD risk are subjected to maturational processes and ramifications of illness duration over the life span, these findings may not readily transfer to adolescents. Methods: The relationship between subclinical hypothyroidism and MDD was studied in a representative subsample of the nationwide KIGGS ("The German Health Interview and Examination Survey for Children and Adolescents") survey. A total of 4118 adolescents were examined over a median period of 6 years, and data were analyzed by a logistic regression approach accounting for important covariates related to thyroid function and/or MDD risk. The same approach was chosen to investigate the relationship between quartiles of thyrotropin (TSH) and free thyroxine (fT4) levels and incident MDD in euthyroid participants to broaden the focus on the relationship between thyroid hormone levels and MDD in a dose-response manner. Results: During the observation period, 121 cases of MDD were reported. There was no association between subclinical hypothyroidism and MDD when comparing 111 adolescents with subclinical hypothyroidism with 4007 euthyroid adolescents, representative of ∼106,000 and 3,610,000 adolescents from the general pediatric population, respectively. This also applied when studying the relationship between quartiles of TSH and fT4 levels and MDD in euthyroid participants. All results were confirmed by sensitivity analyses accounting for thyroid autoimmunity. Conclusions: Consistent with findings in adults, there is no association between subclinical hypothyroidism or quartiles of TSH and fT4 levels in the normal range and MDD in adolescents, despite potential age-related differences regarding thyroid function and MDD risk.
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Affiliation(s)
- Raphael Hirtz
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Corinna Grasemann
- Department of Pediatrics and Center for Rare Diseases Ruhr CeSER, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
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19
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Ganjeh P, Hagmayer Y, Meyer T, Kuhnert R, Ravens-Sieberer U, von Steinbuechel N, Rothenberger A, Becker A. Physical activity and the development of general mental health problems or attention-deficit hyperactivity disorder (ADHD) symptoms in children and adolescents: A cross-lagged panel analysis of long-term follow-up epidemiological data. Front Behav Neurosci 2022; 16:933139. [PMID: 36177095 PMCID: PMC9513200 DOI: 10.3389/fnbeh.2022.933139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Studies have shown that physical activity (PA) can provide a helpful, low-risk, and cost-effective intervention for children and adolescents suffering from mental health problems. This longitudinal study aimed to assess whether PA prevents the development of mental health problems, such as attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Data were analyzed from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected from more than 15.000 children and adolescents at three different time points over a period of more than 10 years. Parents scored the PA of the study participants on three frequency levels according to WHO recommendations, and mental health problems were assessed by means of the Strengths and Difficulties Questionnaire (SDQ). The total problem score (SDQ-Total) and the hyperactivity/inattention symptoms sub-scale (SDQ-H/I) were used in an autoregressive cross-lagged model to examine their relationship with PA. The results showed that PA of boys and girls at preschool age was inversely associated with the occurrence of mental health problems and, in particular, ADHD symptoms about 6 years later. Higher levels of PA were associated with better general mental health and fewer ADHD symptoms at the next time point (Wave 1). These effects were not observed from preadolescence (Wave 1) to adolescence (Wave 2), neither for girls nor for boys. These findings indicate that medium-to-high PA may be a supportive factor for good mental health in children in preschool and elementary school. Future studies will have to show whether PA may be a helpful add-on for interventional programs for improving general mental health and alleviating ADHD symptoms among children and adolescents.
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Affiliation(s)
- Parisa Ganjeh
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- *Correspondence: Parisa Ganjeh
| | - York Hagmayer
- Department of Cognitive Science and Decision Psychology, Georg-Elias-Müller-Institute for Psychology, University of Göttingen, Göttingen, Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Ronny Kuhnert
- Unit Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
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Cohrdes C, Meyrose AK, Ravens-Sieberer U, Hölling H. Adolescent Family Characteristics Partially Explain Differences in Emerging Adulthood Subjective Well-Being After the Experience of Major Life Events: Results from the German KiGGS Cohort Study. JOURNAL OF ADULT DEVELOPMENT 2022. [DOI: 10.1007/s10804-022-09424-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractExperiences from major life events (MLEs; e.g., starting work or living independently) accumulate in the transition to emerging adulthood. Adaption to such events, often operationalized as responses in subjective well-being (SWB), is highly diverse. This observation has prompted attempts to explain differences in SWB responses among individuals as well as events. Early family characteristics have been discussed as potentially enduringly beneficial or harmful for successful adaption to MLEs in emerging adulthood. In the current study, we investigated adolescent family characteristics as longitudinal predictors of emerging adult mental and physical SWB (direct associations) and their explanatory value for SWB differences after the experience of MLEs (indirect associations). Analyses were based on data from a German national cohort study of 6255 emerging adults (KiGGS survey; 46.6% male; mean age = 22.78 years, standard deviation = 3.26 years) who had participated in the baseline study 11 years prior. Results showed that, while experiencing unemployment or severe illness was most negatively related to SWB, high educational attainment had the most positive correlation. Adolescent family characteristics were longitudinal predictors of emerging adult SWB and partially explained differences in SWB after the experience of several MLEs. Most notably, adolescent family characteristics were indirectly associated with emerging adult SWB via permanent relationships, educational attainment, and unemployment. The results provide a basis for the better understanding and further development of research and targeted intervention or prevention measures to facilitate adaptive capacity and reduce adverse effects from certain events on SWB in the transition to emerging adulthood.
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21
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Hintzpeter B, Krause L, Vogelgesang F, Prütz F. Sexual and contraceptive behaviour of young adults in Germany - Results from KiGGS Wave 2. JOURNAL OF HEALTH MONITORING 2022; 7:7-20. [PMID: 35891941 PMCID: PMC9275521 DOI: 10.25646/9873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/24/2022] [Indexed: 11/17/2022]
Abstract
Sexual behaviour is an important aspect of sexual health. 18-year-old and older participants of the KiGGS cohort in KiGGS Wave 2 were asked about their sexual and contraceptive behaviour. Data from 2,966 women and 2,206 men were included in the analysis, which was adjusted to the age and sex distribution of the German population by means of weighting. More than half of the respondents report their first sexual intercourse before reaching the age of majority (women 61%, men 53%). Women report a lower age than men. With regard to the number of opposite-sex sexual partners in the last twelve months, almost 69% of women and 58% of men state that they have had contact. Three or more sexual partners were reported by 11% of women and 20% of men. 7.4% of women have same-sex and 1.4% have both same-sex and opposite-sex sexual contacts, among men the figures are 2.8% and 0.4%, respectively. When asked about the type of contraception used during the last sexual intercourse, about two thirds of the women and more than half of the men indicated the pill; a condom is used by about 44% of the women and about two thirds of the men. Almost one third of the women have already taken the morning-after pill. Overall, the results can help to support prevention and education campaigns on sexual and reproductive health.
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Affiliation(s)
- Birte Hintzpeter
- Corresponding author Dr Birte Hintzpeter, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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22
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Lucas-Herald AK, Delles C. Carotid Intima-Media Thickness Is Associated With Obesity and Hypertension in Young People. Hypertension 2022; 79:1177-1179. [PMID: 35544586 DOI: 10.1161/hypertensionaha.122.19163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Angela K Lucas-Herald
- Developmental Endocrinology Research Group, School of Medicine, Dentistry and Nursing, University of Glasgow (A.K.L.-H.), University of Glasgow, United Kingdom
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Centre for Research Excellence (A.K.L.-H., C.D.), University of Glasgow, United Kingdom
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Centre for Research Excellence (A.K.L.-H., C.D.), University of Glasgow, United Kingdom
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23
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Neuhauser HK, Büschges J, Schaffrath Rosario A, Schienkiewitz A, Sarganas G, Königstein K, Schweizer D, Schmidt-Trucksäss A. Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort. Hypertension 2022; 79:1167-1176. [PMID: 35255707 DOI: 10.1161/hypertensionaha.121.18521] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed to derive carotid intima media thickness (CIMT) percentiles from a population-based sample of adolescents and young adults using improved technology, standardization and quality control, and to investigate the association of CIMT with hypertensive blood pressure (BP) and obesity. METHODS Four thousand seven hundred nine 14- to 28-year-old participants of the German KiGGS cohort 11-year follow-up, which was based on a nationwide population sample, had B-mode ultrasound CIMT measurement with semi-automated edge-detection and automatic ECG-gated real-time quality control. CIMT percentiles were estimated from far wall CIMT during 2 to 6 heart cycles using the GAMLSS statistical model. Hypertensive BP, overweight, obesity, and a risk score from added Z scores of triglycerides, total/HDL (high-density lipoprotein)-cholesterol ratio, and glycated hemoglobin were based on standardized measurements at baseline and follow-up. RESULTS CIMT differed by sex at all ages, furthermore by age and height in a nonlinear fashion. Percentiles were estimated simultaneously by age and height. Hypertensive BP and obesity were associated cross-sectionally and longitudinally with a higher risk of CIMT ≥75th percentile in log-binomial regression models adjusted for age, sex, height, current smoking, and cardiovascular risk score. For CIMT ≥90th percentile, the relative risk effect estimates were consistently >1 but often had large confidence intervals including 1, largest adjusted relative risk 3.37 (95% CI, 1.41-8.04) for the combination of hypertensive BP and obesity at follow-up. CONCLUSIONS Based on state-of-the-art measurements and statistical techniques, these population-based CIMT percentiles by sex, age and height add unbiased evidence for the association of subclinical atherosclerosis with hypertensive BP and obesity in the young.
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Affiliation(s)
- Hannelore K Neuhauser
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany (H.K.N., J.B., A.S.R., A.S., G.S.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (H.K.N., J.B., A.S., G.S., K.K.)
| | - Julia Büschges
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany (H.K.N., J.B., A.S.R., A.S., G.S.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (H.K.N., J.B., A.S., G.S., K.K.)
| | - Angelika Schaffrath Rosario
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany (H.K.N., J.B., A.S.R., A.S., G.S.)
| | - Anja Schienkiewitz
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany (H.K.N., J.B., A.S.R., A.S., G.S.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (H.K.N., J.B., A.S., G.S., K.K.)
| | - Giselle Sarganas
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany (H.K.N., J.B., A.S.R., A.S., G.S.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (H.K.N., J.B., A.S., G.S., K.K.)
| | - Karsten Königstein
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (H.K.N., J.B., A.S., G.S., K.K.).,Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Switzerland (K.K., A.S.-T.)
| | | | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Switzerland (K.K., A.S.-T.)
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24
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Burchartz A, Oriwol D, Kolb S, Schmidt SCE, von Haaren-Mack B, Niessner C, Woll A. Impact of weekdays versus weekend days on accelerometer measured physical behavior among children and adolescents: results from the MoMo study. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00811-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractStructured activities, in which children participate for example at school, are consistent and limited in scope. After-school or weekend activities, by contrast, involve a wider range of behaviors. Studies have shown that physical activity (PA), as measured by accelerometers, is lower on weekends compared to weekdays or school days, whereas PA does not differ between weekdays. In the present study, we examined accelerometer data of children and adolescents living in Germany for the different weekdays and weekend days. The current analysis used cross-sectional data of participants (n = 2743) aged 6–17 years collected between 2014 and 2017. The final valid sample consisted of 2278 children and adolescents divided into three age groups (6–10 years, n = 713; 11–13 years, n = 706; 14–17 years, n = 859) and two gender groups (1072 boys, 1206 girls). Physical behavior, including sedentary behavior, as well as light, moderate, vigorous PA, and wear time were analyzed. Absolute and percentage intensity distributions were evaluated daily. The average wear time was 807 min daily from Monday–Thursday with significant deviations from the mean on Friday (+38 min), Saturday (−76 min), and Sunday (−141 min). Absolute moderate to vigorous PA times were lower on weekends than during the week. However, the percentage intensity distribution remained constant over all days. Girls were less physically active and more sedentary than boys (F1,2272 = 38.3; p < 0.01) and adolescents were significantly less active than younger children (F2,2272 = 138.6; p < 0.01). Waking times increased with age (F2,2272 = 138.6; p < 0.01). Shorter awake periods limit possible active times on weekends, resulting in lower PA and sedentary behavior compared to weekdays. The percentage distributions of the different physical behavior intensity categories are similar over all weekdays and weekend days. We could not find a justification for specific weekend interventions. Instead, interventions should generally try to shift activity away from sedentary behavior towards a more active lifestyle.
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Gomes D, Le L, Perschbacher S, Haas NA, Netz H, Hasbargen U, Delius M, Lange K, Nennstiel U, Roscher AA, Mansmann U, Ensenauer R. Predicting the earliest deviation in weight gain in the course towards manifest overweight in offspring exposed to obesity in pregnancy: a longitudinal cohort study. BMC Med 2022; 20:156. [PMID: 35418073 PMCID: PMC9008920 DOI: 10.1186/s12916-022-02318-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 02/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obesity in pregnancy and related early-life factors place the offspring at the highest risk of being overweight. Despite convincing evidence on these associations, there is an unmet public health need to identify "high-risk" offspring by predicting very early deviations in weight gain patterns as a subclinical stage towards overweight. However, data and methods for individual risk prediction are lacking. We aimed to identify those infants exposed to obesity in pregnancy at ages 3 months, 1 year, and 2 years who likely will follow a higher-than-normal body mass index (BMI) growth trajectory towards manifest overweight by developing an early-risk quantification system. METHODS This study uses data from the prospective mother-child cohort study Programming of Enhanced Adiposity Risk in CHildhood-Early Screening (PEACHES) comprising 1671 mothers with pre-conception obesity and without (controls) and their offspring. Exposures were pre- and postnatal risks documented in patient-held maternal and child health records. The main outcome was a "higher-than-normal BMI growth pattern" preceding overweight, defined as BMI z-score >1 SD (i.e., World Health Organization [WHO] cut-off "at risk of overweight") at least twice during consecutive offspring growth periods between age 6 months and 5 years. The independent cohort PErinatal Prevention of Obesity (PEPO) comprising 11,730 mother-child pairs recruited close to school entry (around age 6 years) was available for data validation. Cluster analysis and sequential prediction modelling were performed. RESULTS Data of 1557 PEACHES mother-child pairs and the validation cohort were analyzed comprising more than 50,000 offspring BMI measurements. More than 1-in-5 offspring exposed to obesity in pregnancy belonged to an upper BMI z-score cluster as a distinct pattern of BMI development (above the cut-off of 1 SD) from the first months of life onwards resulting in preschool overweight/obesity (age 5 years: odds ratio [OR] 16.13; 95% confidence interval [CI] 9.98-26.05). Contributing early-life factors including excessive weight gain (OR 2.08; 95% CI 1.25-3.45) and smoking (OR 1.94; 95% CI 1.27-2.95) in pregnancy were instrumental in predicting a "higher-than-normal BMI growth pattern" at age 3 months and re-evaluating the risk at ages 1 year and 2 years (area under the receiver operating characteristic [AUROC] 0.69-0.79, sensitivity 70.7-76.0%, specificity 64.7-78.1%). External validation of prediction models demonstrated adequate predictive performances. CONCLUSIONS We devised a novel sequential strategy of individual prediction and re-evaluation of a higher-than-normal weight gain in "high-risk" infants well before developing overweight to guide decision-making. The strategy holds promise to elaborate interventions in an early preventive manner for integration in systems of well-child care.
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Affiliation(s)
- Delphina Gomes
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lien Le
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sarah Perschbacher
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Nikolaus A Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Heinrich Netz
- Division of Pediatric Cardiology and Intensive Care, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Uwe Hasbargen
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maria Delius
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kristin Lange
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Uta Nennstiel
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Adelbert A Roscher
- Department of Pediatrics, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Regina Ensenauer
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany. .,Institute of Child Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany.
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Rattay P, Blume M, Wachtler B, Wollgast L, Spallek J, Hoffmann S, Sander L, Herr R, Herke M, Reuter M, Novelli A, Hövener C. Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study. PLoS One 2022; 17:e0266463. [PMID: 35390046 PMCID: PMC8989218 DOI: 10.1371/journal.pone.0266463] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/21/2022] [Indexed: 11/19/2022] Open
Abstract
Objective
Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family’s socioeconomic position and adolescents’ self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants.
Methods
Using data from wave 2 of the”German Health Interview and Examination Survey for Children and Adolescents” (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents’ subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity).
Results
A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained.
Conclusion
The analysis revealed how a family’s position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).
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Affiliation(s)
- Petra Rattay
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
- * E-mail:
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Lina Wollgast
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Lydia Sander
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Raphael Herr
- Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - Max Herke
- Medical Faculty, Institute of Medical Sociology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Marvin Reuter
- Medical Faculty, Institute of Medical Sociology, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna Novelli
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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Does a one-week health program promote well-being among caregiving parents? A quasiexperimental intervention study in Germany. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01671-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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28
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Lange K, Ernst G, Kordonouri O, Danne T, Saßmann H. Typ-1-Diabetes im Jugendalter: Verantwortung übernehmen. DIABETOLOGE 2022. [DOI: 10.1007/s11428-021-00853-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Königstein K, Büschges JC, Sarganas G, Krug S, Neuhauser H, Schmidt-Trucksäss A. Exercise and Carotid Properties in the Young-The KiGGS-2 Study. Front Cardiovasc Med 2022; 8:767025. [PMID: 35071349 PMCID: PMC8766972 DOI: 10.3389/fcvm.2021.767025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Carotid intima-media thickness (cIMT) and stiffness (cS) are predictive markers of early vascular aging and atherosclerotic risk. This study assessed, whether exercise has protective effects on carotid structure and function or on vascular risk in the young. Methods: Volume and change of exercise (recreational and organized sports participation) of German adolescents and young adults was assessed within the prospective population-study KiGGS at KiGGS-Wave-1 (2009-2012) and KiGGS-Wave-2 (2014-2017) using standardized self-reporting questionnaires. CIMT and cS were measured by real-time B-mode ultrasound sequences with semi-automated edge-detection and automatic electrocardiogram-gated quality control in 2,893 participants (14-28 years, 49.6% female). A cumulative index for atherosclerotic risk (CV-R) included z-scores of mean arterial pressure, triglycerides, total/HDL-cholesterol-ratio, body mass index, and HbA1c. Results: At KiGGS-Wave-2 cross-sectional CV-R but not cS and cIMT was lower in all exercise-groups compared to "no exercise" (B = -0.73, 95%-CI = -1.26 to 0.19, p = 0.008). Longitudinal volume of exercise was negatively associated with CV-R (B = -0.37, 95%-CI = -0.74 to 0.00, p = 0.048) but not with cS and cIMT. Cross-sectional relative risk of elevated CV-R but not cS and cIMT was lower in all exercise-groups compared to "no exercise" (RR = 0.80, 95%-CI = 0.66 to 0.98, p = 0.033). High exercise volumes were associated with lower relative risk of elevated CV-R (RR = 0.80, 95%-CI = 0.65-0.97, p = 0.021) and cS in tendency but not with cIMT. Conclusions: Increased levels of exercise are associated with a better cardiovascular risk profile in young individuals, but not with cS and cIMT. Our study confirms previous recommendations on exercise in this age group without demonstrating a clear benefit on surrogate markers of vascular health.
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Affiliation(s)
- Karsten Königstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Julia Charlotte Büschges
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Giselle Sarganas
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Susanne Krug
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Birmili W, Daniels A, Bethke R, Schechner N, Brasse G, Conrad A, Kolossa-Gehring M, Debiak M, Hurraß J, Uhde E, Omelan A, Salthammer T. Formaldehyde, aliphatic aldehydes (C 2 -C 11 ), furfural, and benzaldehyde in the residential indoor air of children and adolescents during the German Environmental Survey 2014-2017 (GerES V). INDOOR AIR 2022; 32:e12927. [PMID: 34473382 DOI: 10.1111/ina.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Indoor air concentrations of formaldehyde, furfural, benzaldehyde, and 11 aliphatic aldehydes (C2 -C11 ) were measured in residences of 639 participants in the German Environmental Survey for Children and Adolescents 2014-2017 (GerES V). Sampling was conducted using passive samplers over periods of approximately seven days for each participant. The most abundant compounds were formaldehyde and hexanal with median concentrations of 24.9 µg m-3 and 10.9 µg m-3 , respectively. Formaldehyde concentrations exceeded the Guide Value I recommended by the German Committee on Indoor Guide Values (Ausschuss für Innenraumrichtwerte - AIR) (0.10 mg m-3 ) for 0.3% of the participating residences. The sum of aliphatic n-aldehydes between C4 (butanal) and C11 (undecanal) exceeded their Guide Value (0.10 mg m-3 ) for 2.0% of the residences. The geometric mean concentrations of most aldehydes were lower than in the earlier GerES IV (2003-2006) study. Formaldehyde and hexanal concentrations, however, were comparable in both studies and showed no significant difference. Indoor aldehyde concentrations did not exhibit significant correlations with factors collected in questionnaires, such as the age of the participants, their socio-economic status, the location of the residence (former East/West Germany), migration background, tobacco exposure, and the type of furniture used. The validity of the passive sampler measurements was verified against active sampling techniques in a test chamber experiment.
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Affiliation(s)
- Wolfram Birmili
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Anja Daniels
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Robert Bethke
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Nadine Schechner
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Gregor Brasse
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - André Conrad
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Marike Kolossa-Gehring
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Malgorzata Debiak
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Julia Hurraß
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
- Department of Infection Control and Environmental Hygiene, Cologne Health Authority, Cologne, Germany
| | - Erik Uhde
- Department of Material Analysis and Indoor Chemistry, Fraunhofer WKI, Braunschweig, Germany
| | - Alexander Omelan
- Department of Material Analysis and Indoor Chemistry, Fraunhofer WKI, Braunschweig, Germany
| | - Tunga Salthammer
- Department of Material Analysis and Indoor Chemistry, Fraunhofer WKI, Braunschweig, Germany
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Meißner C, Meyrose AK, Kaman A, Michalkiewicz M, Ravens-Sieberer U. Associations Between Mental Health Problems in Adolescence and Educational Attainment in Early Adulthood: Results of the German Longitudinal BELLA Study. Front Pediatr 2022; 10:828085. [PMID: 35281228 PMCID: PMC8914221 DOI: 10.3389/fped.2022.828085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Mental health problems (MHP) in adolescence are a major public health concern of the 21st century. Global prevalence estimates range between 10 and 20%. Most MHP manifest by adolescence and persistence rates are high, often accumulating further impairment in early adulthood and beyond. We analyzed data of N = 433 participants from the German longitudinal BELLA study to examine whether MHP in adolescence negatively affect educational attainment in early adulthood. Externalizing and internalizing MHP among adolescents aged 11-17 years were assessed at baseline using the Strengths and Difficulties Questionnaire. Educational attainment was assessed at the 6-year follow-up based on level of education, failure to attain the expected level of education, and dropout from vocational or academic training. Findings from logistic regression analyses suggest that more pronounced externalizing MHP in adolescence predict a lower level of education in early adulthood. We did not find a corresponding effect for internalizing MHP. Adolescents with higher-educated parents were less likely to attain a lower level of education themselves and less likely to fail in attaining their expected level of education. Our findings support that educational attainment presents a central channel for intergenerational reproduction of education and forms an important pathway for upward, but also downward social mobility. The current study emphasizes school as a central setting to implement measures to prevent onset and persistence of MHP and to foster equal opportunities in education.
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Affiliation(s)
- Carina Meißner
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Michalkiewicz
- Institute for Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jarnig G, Jaunig J, Kerbl R, Lima RA, van Poppel MNM. A Novel Monitoring System (AUT FIT) for Anthropometrics and Physical Fitness in Primary School Children in Austria: A Cross-Sectional Pilot Study. Sports (Basel) 2021; 10:sports10010004. [PMID: 35050969 PMCID: PMC8822895 DOI: 10.3390/sports10010004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Monitoring of anthropometric and physical fitness parameters in primary school children is important for the prevention of future health problems. Many of the existing test batteries that are useful for monitoring require expensive test materials, specialized test administrators, and a lot of space. This limits the usefulness of such tests for widespread use. The aim of this pilot study was to design and evaluate monitoring tools for anthropometrics and physical fitness tests in primary schools, called AUT FIT. The test battery consists of height, weight, and waist circumference measurement and eight fitness tests (6 min run, V sit-and-reach, jumping sideways, standing long jump, medicine ball throw, 4 × 10 m shuttle run, ruler drop, single leg stand). Data of 821 children aged 7 to 10 years were gathered. Most AUT FIT tests showed excellent test–retest and interrater reliability and were easy to implement. Criterion-related validity was evident by a strong correlation between physical education teacher rankings and rank scores for motor fitness. Nationwide implementation in the Austrian school system could be an important component for monitoring and improving the health and fitness of primary school children.
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Affiliation(s)
- Gerald Jarnig
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria; (J.J.); (M.N.M.v.P.)
- Correspondence: ; Tel.: +43-650-7007-999
| | - Johannes Jaunig
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria; (J.J.); (M.N.M.v.P.)
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, LKH Hochsteiermark, 8700 Leoben, Austria;
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, 08830 Barcelona, Spain;
| | - Mireille N. M. van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria; (J.J.); (M.N.M.v.P.)
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Schlack R, Peerenboom N, Neuperdt L, Junker S, Beyer AK. The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. JOURNAL OF HEALTH MONITORING 2021; 6:3-19. [PMID: 35146318 PMCID: PMC8734087 DOI: 10.25646/8863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022]
Abstract
Mental health problems in childhood and adolescence may have effects into adulthood. With the KiGGS cohort, data are available for the first time that can be used to track the effects of internalising and externalising problems in childhood or adolescence into young adulthood on a national database. From the KiGGS baseline survey (2003-2006) to KiGGS Wave 2 (2014-2017), a total of 3,546 children and adolescents aged 11 to 17 years were tracked over a period of eleven years into young adulthood. Mental health problems in childhood or adolescence were variously associated with impaired mental health, lower life satisfaction and poorer quality of life and indicators of sexual and reproductive health in young adulthood. When psychosocial protective factors at the time of the KiGGS baseline survey were considered, the longitudinal correlations of internalising and externalising problems with indicators of mental health, life satisfaction and physical and psychological quality of life decreased, as did, to a lesser extent, the correlations with indicators of sexual and reproductive health and, for externalising disorders, also with low educational status (reference: medium). Implications for prevention and intervention are discussed.
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Affiliation(s)
- Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Nele Peerenboom
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
- University of Cambridge, Department of Psychiatry
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stephan Junker
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Neumann A, Hense H, Baum F, Kliemt R, Seifert M, Harst L, Kubat D, Maicher B, Schrey C, Schmitt J, Pfennig A, Weinhold I, Swart E, Soltmann B. Evaluation of a flexible and integrative psychiatric care model in a department of child and adolescent psychiatry in Tübingen, Germany: study protocol (EVA_TIBAS). BMC Health Serv Res 2021; 21:1262. [PMID: 34802427 PMCID: PMC8606248 DOI: 10.1186/s12913-021-07226-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/27/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Model projects for flexible and integrated treatment (FIT) in Germany aim at advancing the quality of care for people with mental disorders. A new FIT model project was established in 2017 at the Department of child and adolescent psychiatry (KJP) of the University Hospital Tübingen (Universitätsklinikum Tübingen, UKT). The study design of EVA_TIBAS presented here describes the evaluation of the FIT model project at the KJP of the UKT. This evaluation aims at quantifying the anticipated FIT model project changes, which are to improve patients' cross-sectoral care at the same maximum cost as standard care. METHODS EVA_TIBAS is a controlled cohort study using a mix of quantitative and qualitative methods. The FIT evaluation consists of three modules. In Module A, anonymized claims data of a statutory health insurance fund will be used to compare outcomes (duration of inpatient and day care psychiatric treatment, inpatient and day care psychiatric length of stay, outpatient psychiatric treatment in hospital, inpatient hospital readmission, emergency admission rate, direct medical costs) of patients treated in the model hospital with patients treated in structurally comparable control hospitals (estimated sample size = ca. 600 patients). In Module B, patient-reported outcomes (health related quality of life, symptom burden, return to psychosocial relationships (e.g. school, friends, hobbies), treatment satisfaction, societal costs) will be assessed quantitatively using validated questionnaires for the model and two control hospitals (estimated sample size = ca. 300 patients). A subsequent health economic evaluation will be based on cost-effectiveness analyses from both the insurance fund's and the societal perspective. In Module C, about 30 semi-structured interviews will examine the quality of offer, effects and benefits of the service offered by the social service of the AOK Baden-Württemberg (for stabilizing the overall situation of care in the family) in the model hospital. A focus group discussion will address the quality of cooperation between employees of the university hospital and the social services. DISCUSSION The results of this evaluation will be used to inform policy makers whether this FIT model project or aspects of it should be implemented into standard care. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov PRS (ID: NCT04727359 , date: 27 January 2021).
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Affiliation(s)
- Anne Neumann
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Helene Hense
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Fabian Baum
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Roman Kliemt
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Martin Seifert
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Lorenz Harst
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Denise Kubat
- Institute of Social Medicine and Health Services Research, Medical Faculty, Otto-von-Guericke- University Magdeburg, Magdeburg, Germany
| | - Birgit Maicher
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Christopher Schrey
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Ines Weinhold
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Enno Swart
- Institute of Social Medicine and Health Services Research, Medical Faculty, Otto-von-Guericke- University Magdeburg, Magdeburg, Germany
| | - Bettina Soltmann
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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A Short Version of the Physical Activity Enjoyment Scale: Development and Psychometric Properties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111035. [PMID: 34769552 PMCID: PMC8582913 DOI: 10.3390/ijerph182111035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 11/21/2022]
Abstract
Objective: The purposes of this paper were to (a) develop a new short, theory-driven, version of the physical activity enjoyment scale (PACES-S) using content analysis; and (b) subsequently to measure the psychometric properties (construct validity, internal consistency, test–retest reliability, and concurrent validity) of the PACES-S for adolescents. Methods: Six experts used a four-point Likert scale to assess the content validity of each of the 16 items of the physical activity enjoyment scale according to a provided definition of physical activity enjoyment. Based on the results, exploratory factor analysis was used to analyze survey data from a longitudinal study of 182 individuals (Measure 1 of Study 1: 15.75 ± 3.39 yrs; 56.6% boys, 43.4% girls), and confirmatory factor analysis (Measure 2 of Study 1: 15.69 ± 3.44 yrs; 56.3% boys, 43.7% girls) was used to analyze the survey data from a cross-sectional study of 3219 individuals (Study 2; 15.99 ± 3.10 yrs; 47.8% boys, 52.2% girls) to assess the construct validity of the new measure. To assess the reliability, test–retest reliability was assessed in Study 1 and internal consistency in Study 1 and 2. For the concurrent validity, correlations with self-reported and device-based physical activity behavior were assessed in both studies. Results: Four out of sixteen items were selected for PACES-S. Exploratory factor analysis and confirmatory factor analyses identified and supported its factorial validity (χ2 = 53.62, df = 2, p < 0.001; RMSEA = 0.073; CFI = 0.99; RFI = 0.96; NFI = 0.99; TLI = 0.96; IFI = 0.99). Results showed good test–retest reliability (r = 0.76) and internal consistency (a = 0.82 to 0.88). Regarding concurrent validity, the results showed positive correlations with a physical activity questionnaire (Study 1: r = 0.36), with a physical activity diary (Study 1: r = 0.44), and with accelerometer-recorded data (Study 1: r = 0.32; Study 2: r = 0.21). Conclusions: The results indicate that PACES-S is a reliable and valid instrument that may be particularly useful to measure physical activity enjoyment in large-scale studies. It shows comparable measurement properties as the long version of PACES.
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Azman Ö, Mauz E, Reitzle M, Geene R, Hölling H, Rattay P. Associations between Parenting Style and Mental Health in Children and Adolescents Aged 11-17 Years: Results of the KiGGS Cohort Study (Second Follow-Up). CHILDREN (BASEL, SWITZERLAND) 2021; 8:672. [PMID: 34438563 PMCID: PMC8394813 DOI: 10.3390/children8080672] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Few studies from Germany have investigated the associations between parenting style and children's and adolescents' health. Little attention has been directed to whether these associations vary with familial socioeconomic or migration status. The aim of this analysis was to investigate the association between parenting style and the mental health of children and adolescents aged 11-17 years using data from the KiGGS cohort study (second follow-up). We calculated mean Strengths and Difficulties Questionnaire (SDQ) total difficulties scores stratified by parenting style (authoritative, permissive, demanding-controlling, emotional distancing). Linear regression analyses adjusted for age, gender, socioeconomic status, migration status, and family status were performed. We also analyzed moderating effects of socioeconomic and migrations status on associations between parenting style and SDQ scores. There were only small differences between the permissive and the authoritative parenting styles. Significantly higher mean scores were observed for the demanding-controlling and emotional distancing styles for both the mother and father. These associations persisted after full adjustment and did not vary by socioeconomic or migration status. Parenting behavior is an important predictor of children's and adolescents' mental health. The promotion of good relationships within families and improving parenting skills offer promising approaches for health promotion in young people.
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Affiliation(s)
- Özge Azman
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
| | - Elvira Mauz
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
| | - Matthias Reitzle
- Department of Developmental Psychology, Friedrich Schiller University of Jena, Am Steiger 3/1, 07743 Jena, Germany;
| | - Raimund Geene
- Department of Health & Education, Berlin School of Public Health, Alice Salomon University of Applied Sciences, Alice-Salomon-Platz 5, 12627 Berlin, Germany;
| | - Heike Hölling
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
| | - Petra Rattay
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
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Neu MA, Schlecht J, Schmidt MF, Robinson AL, Spix C, Grabow D, Kaatsch P, Erdmann F, Faber J, Urschitz MS. Mental health and health-related quality of life in preschool-aged childhood cancer survivors. Results of the prospective cohort study ikidS-OEVA. Pediatr Blood Cancer 2021; 68:e29039. [PMID: 33960635 DOI: 10.1002/pbc.29039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Long-term survivors of childhood cancer are at increased risk for sequelae such as poor mental health (MH) or impaired health-related quality of life (HrQoL). We aimed to evaluate early adverse effects on MH and HrQoL in young childhood cancer survivors (YCCS) before school entry. METHODS In a nationwide prospective cohort study, children with cancer other than brain tumors diagnosed at preschool age and completed cancer treatments were identified from the German Childhood Cancer Registry. The comparison group was children of the same age without a cancer diagnosis who participated in the prospective population-based health survey ikidS. MH problems and HrQoL were assessed by parental versions of the Strengths and Difficulties Questionnaire (SDQ) and the questionnaire for health-related quality of life in children (KINDL), respectively. Associations between cancer and MH as well as HrQoL were analyzed by multivariable linear regression. RESULTS Of 382 YCCS contacted, 145 were enrolled (mean age 6.6 years) and 124 analyzed. Compared to children without a cancer diagnosis (3683 contacted, 2003 enrolled, 1422 analyzed), YCCS had more MH problems (13% vs. 3%) and slightly worse HrQoL (median 78.7 vs. 80.2 points). In the adjusted analysis, YCCS had higher SDQ scores (2.2 points, 95% confidence interval [CI] 1.3, 3.0) and lower KINDL scores (-2.4 points, 95% CI -3.7, -1.1) compared to children without cancer diagnosis. CONCLUSION Already at preschool age, YCCS may be at increased risk of MH problems and impaired HrQoL. This could have impacts on subsequent school performance and educational attainment. Follow-up health care for YCCS may include early screening for MH problems and reasons for HrQoL deficits.
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Affiliation(s)
- Marie A Neu
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jennifer Schlecht
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Martina F Schmidt
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Abigale L Robinson
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Spix
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Desiree Grabow
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter Kaatsch
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Woll A, Klos L, Burchartz A, Hanssen-Doose A, Niessner C, Oriwol D, Schmidt SCE, Bös K, Worth A. Cohort Profile Update: The Motorik-Modul (MoMo) Longitudinal Study-physical fitness and physical activity as determinants of health development in German children and adolescents. Int J Epidemiol 2021; 50:393-394. [PMID: 33709121 DOI: 10.1093/ije/dyaa281] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/06/2021] [Indexed: 01/10/2023] Open
Affiliation(s)
- Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Leon Klos
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Anke Hanssen-Doose
- Institute of Physical Education and Sports, University of Education Karlsruhe, Karlsruhe, Germany
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen C E Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Klaus Bös
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Annette Worth
- Institute of Physical Education and Sports, University of Education Karlsruhe, Karlsruhe, Germany
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Nees F, Deserno L, Holz NE, Romanos M, Banaschewski T. Prediction Along a Developmental Perspective in Psychiatry: How Far Might We Go? Front Syst Neurosci 2021; 15:670404. [PMID: 34295227 PMCID: PMC8290854 DOI: 10.3389/fnsys.2021.670404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/15/2021] [Indexed: 01/21/2023] Open
Abstract
Most mental disorders originate in childhood, and once symptoms present, a variety of psychosocial and cognitive maladjustments may arise. Although early childhood problems are generally associated with later mental health impairments and psychopathology, pluripotent transdiagnostic trajectories may manifest. Possible predictors range from behavioral and neurobiological mechanisms, genetic predispositions, environmental and social factors, and psychopathological comorbidity. They may manifest in altered neurodevelopmental trajectories and need to be validated capitalizing on large-scale multi-modal epidemiological longitudinal cohorts. Moreover, clinical and etiological variability between patients with the same disorders represents a major obstacle to develop effective treatments. Hence, in order to achieve stratification of patient samples opening the avenue of adapting and optimizing treatment for the individual, there is a need to integrate data from multi-dimensionally phenotyped clinical cohorts and cross-validate them with epidemiological cohort data. In the present review, we discuss these aspects in the context of externalizing and internalizing disorders summarizing the current state of knowledge, obstacles, and pitfalls. Although a large number of studies have already increased our understanding on neuropsychobiological mechanisms of mental disorders, it became also clear that this knowledge might only be the tip of the Eisberg and that a large proportion still remains unknown. We discuss prediction strategies and how the integration of different factors and methods may provide useful contributions to research and at the same time may inform prevention and intervention.
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Affiliation(s)
- Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, University of Kiel, Kiel, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lorenz Deserno
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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40
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Burchartz A, Oriwol D, Kolb S, Schmidt SCE, Wunsch K, Manz K, Niessner C, Woll A. Comparison of self-reported & device-based, measured physical activity among children in Germany. BMC Public Health 2021; 21:1081. [PMID: 34090411 PMCID: PMC8180063 DOI: 10.1186/s12889-021-11114-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As children show a more complex but less structured movement behavior than adults, assessment of their many spontaneous and impulsive movements is a challenge for physical activity (PA) assessment. Since neither questionnaires nor accelerometers enable optimal detection of all facets of PA, a multimodal, combined approach of self-reported and device-based methods is recommended. Based on the number of days on which the participants reached the physical activity (PA) values given in the WHO guideline, this study examines 1) the difference between self-reported and device-based, measured PA and 2) whether PA differences between age and gender groups obtained by two methods are comparable. METHODS Participants aged 6-17 years were randomly chosen and data were collected representatively at 167 sample points throughout Germany within the Motorik-Modul Study. PA of n = 2694 participants (52.3% female) was measured using the ActiGraph accelerometer (ACC) and a physical activity questionnaire (PAQ). The sample was divided into three age groups (6-10 yrs. n = 788, 11-13 yrs. n = 823, 14-17 yrs. n = 1083). Numbers of days per week with at least 60 min moderate to vigorous PA (MVPA) were analyzed for both methods. RESULTS Only every 25th respondent (4%) reaches the WHO standard of 60 min MVPA every day if measured with ACC. Self-reported PA was slightly higher (9%) (meanPAQ = 3.82 days; meanACC = 2.34 days; Fmethod = 915.85; p = <.001; fCohen = .64). The differences between the methods are significantly smaller in younger children than in the older age groups (Fage = 264.2, p < .001; fCohen = .48). The older the subjects are, the lower is the proportion of those who meet the WHO guideline on each day, with girls meeting the guideline less frequently than boys in all age groups. CONCLUSION Children and adolescents living in Germany show a very low adherence to the WHO guideline on PA. While younger children are much more active with their free play, especially children over 10 years of age and especially girls should be the target of programs to increase PA.
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Affiliation(s)
- Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany.
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany
| | - Simon Kolb
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany
| | - Steffen C E Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany
| | - Kristin Manz
- Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Building 40.40, 76131, Karlsruhe, Germany
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Krause L, Vogelgesang F, Thamm R, Schienkiewitz A, Damerow S, Schlack R, Junker S, Mauz E. Individual trajectories of asthma, obesity and ADHD during the transition from childhood and adolescence to young adulthood. JOURNAL OF HEALTH MONITORING 2021; 6:2-15. [PMID: 35586784 PMCID: PMC8832367 DOI: 10.25646/7913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/21/2021] [Indexed: 11/05/2022]
Abstract
The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) provides comprehensive and reliable data on the health situation of the upcoming generation. The KiGGS cohort accompanies participants from the KiGGS baseline study (2003-2006) into adulthood. Until now, two follow-up surveys of the cohort have been implemented with KiGGS Wave 1 (2009-2012) and KiGGS Wave 2 (2014-2017). In KiGGS Wave 2, the cohort was supplemented by the in-depth study 'Family and care-specific factors influencing the development, trajectories and effects of mental disorders (especially ADHD), obesity and allergic diseases (especially asthma)'. One aim of the study was to identify individual trajectories of these health disorders. For this purpose, probabilities for typical transitions from the KiGGS baseline study to KiGGS Wave 2 were calculated. An important result is that many participants who had asthma, obesity or ADHD at KiGGS baseline still had the disease more than ten years later: Over a third still had asthma (35%) or ADHD (37%), and almost half were still affected by obesity (47%). The results point to the need for early preventive measures to stop these potentially chronic diseases from developing in childhood and adolescence.
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Affiliation(s)
- Laura Krause
- Corresponding author Dr Laura Krause, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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Krause L, Vogelgesang F, Thamm R, Schienkiewitz A, Damerow S, Schlack R, Junker S, Mauz E. Individual trajectories of asthma, obesity and ADHD during the transition from childhood and adolescence to young adulthood. JOURNAL OF HEALTH MONITORING 2021. [PMID: 35586784 DOI: 10.25646/9178:1-65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) provides comprehensive and reliable data on the health situation of the upcoming generation. The KiGGS cohort accompanies participants from the KiGGS baseline study (2003-2006) into adulthood. Until now, two follow-up surveys of the cohort have been implemented with KiGGS Wave 1 (2009-2012) and KiGGS Wave 2 (2014-2017). In KiGGS Wave 2, the cohort was supplemented by the in-depth study 'Family and care-specific factors influencing the development, trajectories and effects of mental disorders (especially ADHD), obesity and allergic diseases (especially asthma)'. One aim of the study was to identify individual trajectories of these health disorders. For this purpose, probabilities for typical transitions from the KiGGS baseline study to KiGGS Wave 2 were calculated. An important result is that many participants who had asthma, obesity or ADHD at KiGGS baseline still had the disease more than ten years later: Over a third still had asthma (35%) or ADHD (37%), and almost half were still affected by obesity (47%). The results point to the need for early preventive measures to stop these potentially chronic diseases from developing in childhood and adolescence.
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Affiliation(s)
- Laura Krause
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Roma Thamm
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Anja Schienkiewitz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stefan Damerow
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stephan Junker
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Elvira Mauz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Hetzel C, Schreiner S, Kühl D, Bühne D, Philippi K, Froböse I. [Effect of a One-Week Health Program on the Mental Health of Caregiving Parents: A Controlled Panel Study]. DAS GESUNDHEITSWESEN 2021; 84:1022-1030. [PMID: 33765687 DOI: 10.1055/a-1386-4029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Parents of children in need of care and home care are a vulnerable group. The aim of this study was to determine the effect of a legally funded, one-week health program of the Social Insurance for Agriculture, Forestry and Horticulture (SVLFG) on the well-being of the participating caregiving. Methods In a controlled panel study (intervention group IG n=23, comparison group n=33, allocation not randomized), the WHO-5 index was collected at several time points of measurement. Evaluation was performed by fixed effects panel regression under control of time-varying characteristics (external conditions, period effects). RESULTS At the start of the intervention, 70% of the IG were at the threshold of clinically relevant depressiveness. After a very clear initial effect, the level remained above the baseline level for up to 15 weeks (under stable conditions). However, a sinking below the initial level was prevented until at least 26 weeks even with significantly increasing stress. CONCLUSION Considering the high initial burden, the effect of the prevention-oriented intervention is persistent over a considerable period of time. The intervention is unique for the social insurance system. The design allows a causal interpretation despite the small number of cases.
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Affiliation(s)
- Christian Hetzel
- Institut für Qualitätssicherung in Prävention und Rehabilitation GmbH an der Deutschen Sporthochschule Köln, Köln, Deutschland
| | - Sieglinde Schreiner
- Gesundheitsangebote, Sozialversicherung für Landwirtschaft, Forsten und Gartenbau, Kassel, Deutschland
| | - Dagmar Kühl
- Prävention, Sozialversicherung für Landwirtschaft, Forsten und Gartenbau, Kassel, Deutschland
| | - David Bühne
- Institut für Qualitätssicherung in Prävention und Rehabilitation GmbH an der Deutschen Sporthochschule Köln, Köln, Deutschland
| | - Katharina Philippi
- Institut für Qualitätssicherung in Prävention und Rehabilitation GmbH an der Deutschen Sporthochschule Köln, Köln, Deutschland
| | - Ingo Froböse
- Institut für Bewegungstherapie und bewegungsorientierte Prävention und Rehabilitation, Deutsche Sporthochschule Köln, Köln, Deutschland
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Königstein K, von Schenck U, Büschges JC, Schweizer D, Vogelgesang F, Damerow S, Sarganas G, Dratva J, Schmidt-Trucksäss A, Neuhauser H. Carotid IMT and Stiffness in the KiGGS 2 National Survey: Third-Generation Measurement, Quality Algorithms and Determinants of Completeness. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:296-308. [PMID: 33221140 DOI: 10.1016/j.ultrasmedbio.2020.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/25/2020] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Abstract
Carotid intima-media thickness (cIMT) and carotid stiffness (CS) are important markers of atherosclerotic risk in the young. We assessed a novel third-generation method for its applicability in large population-based epidemiologic studies to determine strengths, limitations, completeness and predictors of unsuccessful measurement. Four thousand seven hundred ninety-eight 14- to 31-y-old participants of the German KiGGS cohort, which is based on a nationally representative sample with 11-y follow-up, underwent B-mode ultrasound examinations of the left and right common carotid artery with semi-automatic edge detection and automatic electrocardiogram-gated real-time quality control based on a sophisticated snake algorithm and subpixel interpolation. Overall completeness was 98% for far wall cIMT and 89% for CS parameters. Plane-specific completeness varied from 92%-96% for far wall and from 64%-69% for near-wall cIMT. Obesity independently predicted unsuccessful cIMT and CS measurements with odds ratios of 12.67 (95% confidence interval: 5.50-29.19) and 7.30 (4.87-10.94) compared with non-overweight after adjustment for blood pressure, cholesterol, smoking, hazardous drinking, age, sex and sonographer. Inter- and intra-rater reliabilities of cIMT and CS parameters in a sample of 15 young adults were good or excellent. Third-generation cIMT and CS measurements in the young with semi-automatic edge-detection and automatic real-time quality control has been successfully standardized with high reliability and very high completeness in a national survey setting. This provides a strong methodological foundation for further validation of the predictive value of cIMT and CS for atherosclerotic risk in the young.
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Affiliation(s)
- Karsten Königstein
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany; Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland; German Centre for Cardiovascular Research (DZHK), partner site, Berlin, Germany
| | - Ursula von Schenck
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - Julia Charlotte Büschges
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), partner site, Berlin, Germany
| | | | - Felicitas Vogelgesang
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - Stefan Damerow
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - Giselle Sarganas
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), partner site, Berlin, Germany
| | - Julia Dratva
- Medical Faculty, University of Basel, Switzerland; ZHAW School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Hannelore Neuhauser
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), partner site, Berlin, Germany.
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Gruber M, König D, Holzhäuser J, Castillo DM, Blüml V, Jahn R, Leser C, Werneck-Rohrer S, Werneck H. Parental feeding practices and the relationship with parents in female adolescents and young adults with eating disorders: A case control study. PLoS One 2020; 15:e0242518. [PMID: 33212471 PMCID: PMC7676917 DOI: 10.1371/journal.pone.0242518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Perceived parental influence on diet in early adolescence in the context of the parental relationship had previously not been studied in a clinical sample. The aim of this study was to investigate a possible association between eating disorders and characteristics of the relationship with parents and the parental feeding practices in early adolescence. METHODS 21 female adolescents and young adults with an eating disorder (ED)-bulimia nervosa or anorexia nervosa-and 22 females without eating disorder (healthy control; HC), aged between 16 and 26, were assessed via self-report questionnaires for problematic eating behaviour, relationship with parents, perceptions of parent's feeding practices at the age of 10-13 years and personality. Statistical evaluation was performed by means of group comparisons, effect sizes, regression analyses and mediator analyses. RESULTS Adolescent and young adult females with ED reported more fears/overprotection and rejection/neglect by their mothers and less self-responsibility in terms of eating behaviour during adolescence than did the HC. The relationship with the fathers did not differ significantly. Females who perceived more cohesion, rejection/neglect and fears/overprotection by the mother were more likely to suffer from an ED. Rejection/neglect by both parents were associated with less self-acceptance of the young females with even stronger effect sizes for the fathers than the mothers. Harm prevention in the young females was a partial mediator between fears/overprotection and the drive for thinness. CONCLUSIONS The parental relationship is partly reflected in the self-acceptance and self-responsibility in eating of the adolescent and young females, both of them are particularly affected in EDs. Stressors in the parent-child relationship should be targeted in treatment of eating disorders. Nutritional counselling for parents might be useful in early adolescence.
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Affiliation(s)
- Maria Gruber
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel König
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Julika Holzhäuser
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Victor Blüml
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rebecca Jahn
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carmen Leser
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Sonja Werneck-Rohrer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Harald Werneck
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- * E-mail:
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Abstract
BACKGROUND Longitudinal cohort studies with early start and life span perspectives are increasingly recognized as being crucial to uncover developmental trajectories as well as risk and resilience factors of psychiatric disorders. OBJECTIVE The importance of longitudinal studies is presented and the main findings of the Mannheim study of children at risk (MARS), the adolescent brain cognitive development (ABCD), the pediatric and adolescent health survey (Kinder- und Jugendgesundheitssurvey, KiGGS) and the AIMS longitudinal European autism project (LEAP) cohort studies are described. MATERIAL AND METHODS A literature search was carried out in MEDLINE. RESULTS The MARS followed participants with psychosocial and organic risks over more than 30 years starting from birth and showed the importance of early risk factors (prenatal period up to early childhood) for neuropsychosocial development. The ABCD cohort study (start 9-10 years old) underlined the developmental significance of early socioemotional and prenatal risks as well as toxin exposure. The KiGGS cohort followed children and adolescents from age 0-17 years up to the ages of 10-28 years. Main findings underline the importance of the socioeconomic status and gender-specific effects with respect to sensitive periods for the onset and trajectories of psychiatric disorders. The AIMS cohort followed patients with and without autism spectrum disorders aged between 6 and 30 years and first results revealed small effects regarding group differences. Further, cohort studies starting prenatally along with deep phenotyping are warranted to uncover the complex etiology of mental disorders. CONCLUSION Existing cohort studies on early mental development have shown specific focal points. To identify general and specific risk and resilience factors for psychiatric disorders and to model trajectories, there is a need for multimodal integration of data sets.
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Wiegand S, Kühnen P. [Obesity is rarely curable: individual concepts and therapy programs for children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:821-830. [PMID: 32564111 DOI: 10.1007/s00103-020-03164-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Obesity in children has an increased risk to persist in adulthood. In most cases, obesity starts to develop in children at school age. Lower social economic status and migration background are severe risk factors for obesity. Additionally, genetic predisposition for the development of obesity plays an especially important role in children and adolescents. However, the individual cause for obesity is heterogeneous and complex. This is the reason why only a systematic analysis of individually existing problems is necessary for a differentiated and realistic planning of the treatment. Long-lasting therapy concepts need to be based on current available evidence.The treatment of childhood obesity should rely on multiprofessional lifestyle programs. An exception might be rare monogenic or syndromic forms of obesity, because defects within the central regulatory pathways of body weight regulation could be present. In general, a key component of the treatment strategy should include an improvement of nutrition, physical exercise and self-esteem combined with a reduction of stress. Moreover, the inclusion of parents into the treatment strategy has shown to be beneficial and necessary. Long-term follow-up studies on the development of associated comorbidities are rare. Unfortunately, patient groups at risk are currently not necessarily reached with available treatment programs.A multiprofessional analysis of individual problems and differentiated treatment planning with a participative approach (acknowledging the cultural background and involving members of the family) should lead to long-lasting improvement of the therapeutic outcome. The individual main treatment aim should also include - apart from the reduction of body weight - the improvement of associated comorbidities and quality of life, especially by avoiding any stigmatization. A health-promoting environment is desirable for this salutogenetic approach.
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Affiliation(s)
- Susanna Wiegand
- SPZ für chronisch kranke Kinder, Adipositas-Zentrum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Peter Kühnen
- Institut für experimentelle pädiatrische Endokrinologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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Führer A, Tiller D, Brzoska P, Korn M, Gröger C, Wienke A. Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E212. [PMID: 31892226 PMCID: PMC6981556 DOI: 10.3390/ijerph17010212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/02/2022]
Abstract
Background: Migration background is known to be an important risk factor for a number of medical outcomes. Still, relatively little is known about the epidemiologic relevance of different definitions of migration status. Methods: Data from 5250 school entry examinations spanning three consecutive years (2015-2017) were gathered from the Public Health Department in Halle, Germany. Data were stratified according to six different migration statuses and evaluated for differences in health service utilization and developmental outcomes. Results: Compared to non-migrant children, migrant children have a lower utilization of preventative services, and higher frequencies of developmental delays. Children with first-generation migration background consistently show results worse than all others, while children with one-sided second-generation migration background show results similar to those of their non-migrant peers. These findings are not substantially altered by adjustment for social status. Conclusions: Children with first-generation migration background should receive special attention in school entry examinations, since they constitute a group with consistently higher health risks compared to other groups of preschoolers.
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Affiliation(s)
- Amand Führer
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Epidemiology, Biometrics and Informatics, 06112 Halle (Saale), Germany; (D.T.); (M.K.); (A.W.)
| | - Daniel Tiller
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Epidemiology, Biometrics and Informatics, 06112 Halle (Saale), Germany; (D.T.); (M.K.); (A.W.)
| | - Patrick Brzoska
- Health Services Research Unit, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany;
| | - Marie Korn
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Epidemiology, Biometrics and Informatics, 06112 Halle (Saale), Germany; (D.T.); (M.K.); (A.W.)
| | - Christine Gröger
- Public Health Department, City of Halle (Saale), 06112 Halle, Germany;
| | - Andreas Wienke
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Epidemiology, Biometrics and Informatics, 06112 Halle (Saale), Germany; (D.T.); (M.K.); (A.W.)
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