Based on the former phase III module, the multidimensional structure was revised as a phase IV module (EORTC FA12) with an improved scale structure. For a comprehensive validation of the EORTC FA12, further aspects of convergent and divergent validity as well as sensitivity to change should be determined.
BackgroundThe highest incidence and prevalence of mental health problems across the lifespan as well as the first onset of most long-term mental health conditions are reported for youths between 14 and 25 years of age. At the same time, only 25% of adolescents with mental health problems receive professional treatment. One explanation for poor treatment access in youths is their low help-seeking behavior. Barriers that can keep children and adolescents (C&A) from seeking professional help include a lack of perceived need, structural barriers, or stigma. Interventions based on e-technology might present an effective approach, overcoming these barriers by reducing stigma and providing low-threshold access with enhanced reach, ultimately facilitating help-seeking for mental health problems among youths.MethodsThe study is designed as a multi-center, randomized controlled trial. In total, an estimated number of n = 1,500 C&A with mental health problems, drawn from a school-based sample of n = 15,000 pupils attending school grades 6 to 13 (≥ 12 years of age), recruited in five regions of Germany, will be randomized either to an intervention (ProHEAD online) or a control condition. C&A in the intervention group will receive online access to tailored information and individual advice on where to seek professional help for their specific needs close to their place of living, case reports of and interaction with peers, as well as the opportunity for online and telephone counseling. C&A in the control intervention will receive a recommendation to seek help and online information on where to find professional help. All participants will be asked to complete questionnaires concerning their help-seeking behavior at baseline, during the intervention (monitoring), and also at a 1 and 2 year follow-up. The primary endpoint is the number of C&A seeking conventional face-to-face professional help in the real-world setting within 1 year after their initial screening.DiscussionThe trial will investigate if an Internet-based intervention can increase professional help-seeking in C&A with mental health problems. With its randomized controlled design and large-scale school-based sampling, the study aims to overcome the shortages of previous research. The intervention has the potential to narrow the treatment gap in C&A and to ultimately improve the mental health care system.Trial registrationGerman Clinical Trials Register, DRKS00014685. Registered on 7 July, 2018.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3157-7) contains supplementary material, which is available to authorized users.
From April 2003 to June 2012 a total of 17 patients, 8 female and 9 male were surgically treated for claw deformity. The dominant hand was affected in seven patients. The average age was 46 ± 15 (22-80) years, the average interval from onset of ulnar palsy to lassoplasty was 61 ± 91 (3-288) months. The final follow-up was performed after an average of 42 ± 32 (2-112) months. Claw deformity was resolved in 14 out of the 17 patients. The grip strength was on average 58 ± 28 % (11-96 %) of the unaffected hand, the mean disabilities of the arm, shoulder and hand (DASH) score was 32 ± 18 (5-68) points and the degree of patient satisfaction 7 ± 2 (0-10). According to own results and those in the literature lassoplasty can be recommended for the treatment of claw deformity.
The results provide an indication of higher severity of patients in group "postoperative rehabilitation without a period at home". Nevertheless there are some indications for under-utilization of certain patient groups.
Zusammenfassung
Fragestellung Die Studie erhebt Strukturen, Forschungsförderungen sowie -themen der Forschung in der physikalischen und rehabilitativen Medizin (PRM) in Deutschland.
Methode Über einen Fragebogen wurde der Status Quo der Forschung in Deutschland zum Jahr 2016 im Bereich der PMR erfasst. Dieser wurde an 109 Einrichtungen, v. a. Institute, Universitäten und Kliniken verschickt. Die Auswertung erfolgte deskriptiv.
Ergebnisse Rund 77% von 32 rückmeldenden Einrichtungen in der PMR erhielten Drittmittelförderungen. Die wichtigsten Fördermöglichkeiten waren Stiftungen, die Deutsche Rentenversicherung Bund sowie leistungsorientierte Mittelvergabe (LOM) an den Universitäten. Forschung zur Rehabilitation überwiegt gegenüber der Forschungsaktivität in der physikalischen Medizin. Die Themen sind hierbei breit gefächert und reichen von Therapiemittelforschung bis hin zu Rehabilitationszugang und -bedarf. Dabei kommen vorwiegend quantitative Methoden zum Einsatz
Schlussfolgerung Die Erhebung gibt Hinweise auf die bestehende Forschungsstruktur im Bereich der PRM sowie der inhaltlichen Themenfelder. Die Forschung im Bereich der physikalischen Medizin ist gegenüber der Rehabilitationsforschung unterrepräsentiert.
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