ObjectiveThis study’s aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.MethodsWe used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003–2006, follow-up: 2009–2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models.ResultsWe found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents’ health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower.ConclusionsBecause the direct effects of family structure on adolescents’ health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents’ health, prevention programmes and interventions should be directed towards the parent–adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.
Abstract. Most instruments for the assessment of disordered eating were developed and validated in young female samples. However, they are often used in heterogeneous general population samples. Therefore, brief instruments of disordered eating should assess the severity of disordered eating equally well between individuals with different gender, age, body mass index (BMI), and socioeconomic status (SES). Differential item functioning (DIF) of two brief instruments of disordered eating (SCOFF, Eating Attitudes Test [EAT-8]) was modeled in a representative sample of the German population ( N = 2,527) using a multigroup item response theory (IRT) and a multiple-indicator multiple-cause (MIMIC) structural equation model (SEM) approach. No DIF by age was found in both questionnaires. Three items of the EAT-8 showed DIF across gender, indicating that females are more likely to agree than males, given the same severity of disordered eating. One item of the EAT-8 revealed slight DIF by BMI. DIF with respect to the SCOFF seemed to be negligible. Both questionnaires are equally fair across people with different age and SES. The DIF by gender that we found with respect to the EAT-8 as screening instrument may be also reflected in the use of different cutoff values for men and women. In general, both brief instruments assessing disordered eating revealed their strengths and limitations concerning test fairness for different groups.
We report an association of single-nucleotide polymorphisms (SNPs) for the VSNL1 gene (visinin-like 1) with schizophrenia and frontal cortical function in a sample of patients with Diagnostic and Statistical Manual of Mental Disorder-IV (DSM-IV) diagnoses of schizophrenia, compared with healthy controls. Moreover, VSNL1 SNPs were associated with performance in the Wisconsin Card Sorting Test, a measure for the assessment of frontal cortical function. The VSNL1 gene product, Visinin-like-protein-1 (VILIP-1), is a member of the neuronal EF-hand Ca2+-sensor protein family. Previously, VILIP-1 mRNA and protein expression were shown to be altered in animal models and in schizophrenia patients. VILIP-1 influences cytosolic cyclic adenosine mono phosphate (cAMP) levels, cell migration, exocytotic processes and differentiation in the periphery. This raises the question, whether, similar to other potential schizophrenia susceptibility genes such as Disc1, PDE4B and Akt, VSNL1 may affect cAMP signaling and neurite outgrowth in neurons. In dissociated rat hippocampal neurons, VILIP-1 small interfering RNA knockdown decreased cAMP levels and reduced dendrite branching, compared with control-transfected cells. In contrast, VILIP-1 overexpression had the opposite effect. Similar results have been obtained in the human dopaminergic neuronal cell line SH-SY5Y, where the effect on neurite branching and length was attenuated by the adenylyl cyclase inhibitor 2′,5′-dideoxyadenosine and the protein kinase A inhibitor KT5720. These results show that the association of VSNL1 SNPs with the disease and cognitive impairments, together with previously observed pathological changes in VILIP-1 protein expression, possibly occurring during brain development, may contribute to the morphological and functional deficits observed in schizophrenia.
ObjectivesTo identify underlying causes for failure of medical thesis projects and the constantly high drop-out rate in Germany from the supervisors' perspective and to compare the results with the students' perspective.SettingCross-sectional survey. Online questionnaire for survey of medical thesis supervisors among the staff of Charité—Universitätsmedizin Berlin, Germany. Published, earlier longitudinal survey among students for comparison.Participants1069 thesis supervisors participated.Data extraction and synthesisData are presented using descriptive statistics, and the χ2 test served to compare the results among supervisors with the earlier data from the longitudinal survey of doctoral students.Primary and secondary outcomesNot applicable. This survey is an observational study.ResultsOf 3653 potential participants, 1069 (29.3%) supervising 3744 doctoral candidates participated in the study. Supervisors considered themselves to be highly motivated and to offer adequate supervision. On the other hand, 87% stated that they did not feel well prepared for thesis supervision. Supervisors gave lack of timeliness of doctoral students and personal differences (p=0.024 and p=0.001) as the main reasons for terminating thesis projects. Doctoral students predominantly mentioned methodological problems and difficult subjects as critical issues (p=0.001 and p<0.001). Specifically, students felt ill prepared for the statistical part of their research—49.5% stated that they never received statistical assistance, whereas 97% of supervisors claimed to help their students with statistical analysis.ConclusionsThe authors found that both thesis supervisors and medical students feel ill prepared for their roles in the process of a medical dissertation. Contradictory reasons for terminating medical thesis projects based on supervisors' and students' self-assessment suggest a lack of communication and true scientific collaboration between supervisors and doctoral students as the major underlying issue that requires resolution.
The graduate program at Charité has been making a significant contribution towards improved preparation for scientific work and medical dissertations. However, there are still improvements necessary such as better financial support and statistical preparation of medical dissertations.
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