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  • 1
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    Online Resource
    Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic, multicentre, randomised controlled trial (UPSIDES-RCT)
    Springer Science and Business Media LLC ; 2020
    In:  Trials Vol. 21, No. 1 ( 2020-12)
    Details
    In: Trials, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: Peer support is an established intervention involving a person recovering from mental illness supporting others with mental illness. Peer support is an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including service user outcomes (psychosocial and clinical), peer support worker outcomes (work role and empowerment), service outcomes (cost-effectiveness and return on investment), and implementation outcomes (adoption, sustainability and organisational change). Methods UPSIDES-RCT is a pragmatic, parallel-group, multicentre, randomised controlled trial assessing the effectiveness of using peer support in developing empowering mental health services (UPSIDES) at four measurement points over 1 year (baseline, 4-, 8- and 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, UK, Israel, India, Uganda and Tanzania). The primary outcome is social inclusion of service users with severe mental illness ( N  = 558; N  = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (using the Empowerment Scale), hope (using the HOPE scale), recovery (using Stages of Recovery) and health and social functioning (using the Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect and the implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centredness, community participation and the realisation of mental health as a human right. Trial registration ISRCTN, ISRCTN26008944 . Registered on 30 October 2019.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    URL: Article
    DOI: 10.1186/s13063-020-4177-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2040523-6
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  • 2
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    Psychosis Is Mutable over Time: A Longitudinal Psychopathology Study
    S. Karger AG ; 2018
    In:  Psychopathology Vol. 51, No. 3 ( 2018), p. 186-191
    Details
    In: Psychopathology, S. Karger AG, Vol. 51, No. 3 ( 2018), p. 186-191
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 A neurobiologically informed, system-specific psychopathological approach has been suggested for use in schizophrenia. However, to our knowledge, such an approach has not been used to prospectively describe the course of schizophrenia. 〈 b 〉 〈 i 〉 Sampling and Methods: 〈 /i 〉 〈 /b 〉 We assessed psychopathology in a well-described sample of 100 patients with schizophrenia or schizoaffective disorder with the Bern Psychopathology Scale (BPS) at 6-month intervals for up to 18 months. The BPS groups symptoms into the 3 domains language, affectivity and motor behaviour; each domain is rated as being normal, inhibited or disinhibited. In addition, we collected qualitative psychopathological data in the form of case reports. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Forty-eight patients completed at least 2 assessments over the course of at least 1 year. Of these, 16 patients (33.3%) showed a bipolar course pattern (i.e., a switch from inhibited to disinhibited or vice versa) in 1 domain and 6 patients (12.5%) in more than 1 domain. Shifts from 1 dominant domain to another were seen frequently ( 〈 i 〉 n 〈 /i 〉 = 20, 41.7%), but shifts between 1 dominant domain and a combination of dominant domains were more common ( 〈 i 〉 n 〈 /i 〉 = 33, 68.8%). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The course of schizophrenia is heterogeneous and shows frequent changes in psychopathology. This should be taken into account in the communication with patients and in the research on underlying illness mechanisms and treatment. A major limitation of this study is the small sample size.
    Type of Medium: Online Resource
    ISSN: 0254-4962 , 1423-033X
    URL: Article
    DOI: 10.1159/000486897
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1483565-4
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  • 3
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    Eine Theory of Change zur erfolgreichen Implementierung von Peer-Begleitung für Menschen mit schweren psychischen Erkrankungen in Deutschland
    Georg Thieme Verlag KG ; 2023
    In:  PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie Vol. 73, No. 02 ( 2023-02), p. 70-77
    Details
    In: PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, Georg Thieme Verlag KG, Vol. 73, No. 02 ( 2023-02), p. 70-77
    Abstract: Ziel der Studie Peer-Begleitung beschreibt die Unterstützung von Menschen mit psychischen Erkrankungen durch geschulte Peer-Begleiter/-innen, welche bereits eine psychische Krise bewältigt haben. Die Implementierung von Peer-Begleitung ist aufgrund interagierender Faktoren komplex und kann mittels des partizipativen Theory of Change- Ansatzes gelingen. Ziel dieser Arbeit ist die Entwicklung einer zentrumsübergreifenden Theory of Change zur nachhaltigen Implementierung von UPSIDES Peer-Begleitung in Deutschland. Methodik Basierend auf standortspezifischen Theories of Change aus Ulm und Hamburg, an welchen 47 Teilnehmer/-innen mitwirkten, wurde eine zentrumsübergreifende Theory of Change konzipiert und in drei Folgeworkshops mit 12 Teilnehmer/-innen verifiziert. Die Teilnehmer/-innen wiesen diverse berufliche und Erfahrungshintergründe auf: Peer-Begleiter/-innen, Klinikleitung, professionelle Behandler/-innen (Psychiater/-innen, Psychotherapeut/-innen, Krankenpfleger/-innen), Forscher/-innen. Ergebnisse Der erste Pfad der zentrumsübergreifenden Theory of Change fokussiert die Ausbildung zum/zur Peer-Begleiter/-in, wogegen der zweite Pfad die Anerkennung und Integration durch psychiatrische Einrichtungen und Fachkräfte thematisiert. Der dritte Pfad spezifiziert den Aufbau eines berufsübergreifenden Netzwerkes zur Integration verschiedener Peer-Begleitungsangebote. Das Herantreten an potentielle Peer-Klienten/-innen wird im vierten Pfad abgebildet. Der fünfte Pfad umfasst die Auftragsklärung und Implementierung in weiteren Einrichtungen durch Kooperationen. Diskussion Viele der identifizierten Implementierungsschritte wurden in vergleichbaren Studien validiert. Die unter Einbezug vielfältiger Perspektiven der zentralen Akteur/-innen entwickelte Theory of Change ist eine wichtige Grundlage für die nachhaltige Implementierung von UPSIDES Peer-Begleitung. Weiterhin kann sie als Blaupause für die Implementierung ähnlicher Interventionen dienen, um die Verbreitung evidenz-basierter nutzer/-innen-geleiteter und recovery-orientierter Interventionen voranzubringen. Schlussfolgerung Theory of Change ist eine akzeptierte und praktikable Methode, welche für die Implementierung von komplexen Interventionen wie UPSIDES Peer-Begleitung empfohlen werden kann.
    Type of Medium: Online Resource
    ISSN: 0937-2032 , 1439-1058
    URL: Article
    DOI: 10.1055/a-1827-4040
    RVK:
    CL 1000
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 800571-0
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  • 4
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    Diabetes in all hospitalized cases in Germany 2015–2019 and impact of the first COVID-19 year 2020
    Bioscientifica ; 2023
    In:  Endocrine Connections Vol. 12, No. 4 ( 2023-04-01)
    Details
    In: Endocrine Connections, Bioscientifica, Vol. 12, No. 4 ( 2023-04-01)
    Abstract: To analyze the proportion of diabetes among all hospitalized cases in Germany between 2015 and 2020. Methods Using the nationwide Diagnosis-Related-Groups statistics, we identified among all inpatient cases aged ≥ 20 years all types of diabetes in the main or secondary diagnoses based on ICD-10 codes, as well all COVID-19 diagnoses for 2020. Results From 2015 to 2019, the proportion of cases with diabetes among all hospitalizations increased from 18.3% (3.01 of 16.45 million) to 18.5% (3.07 of 16.64 million). Although the total number of hospitalizations decreased in 2020, the proportion of cases with diabetes increased to 18.8% (2.73 of 14.50 million). The proportion of COVID-19 diagnosis was higher in cases with diabetes than in those without in all sex and age subgroups. The relative risk (RR) for a COVID-19 diagnosis in cases with vs without diabetes was highest in age group 40–49 years (RR in females: 1.51; in males: 1.41). Conclusions The prevalence of diabetes in the hospital is twice as high as the prevalence in the general population and has increased further with the COVID-19 pandemic, underscoring the increased morbidity in this high-risk patient group. This study provides essential information that should help to better estimate the need for diabetological expertise in inpatient care settings.
    Type of Medium: Online Resource
    ISSN: 2049-3614
    URL: Article
    DOI: 10.1530/EC-22-0475
    Language: Unknown
    Publisher: Bioscientifica
    Publication Date: 2023
    detail.hit.zdb_id: 2668428-7
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  • 5
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    Angst und Depression bei Typ-1-Diabetes – Erste Ergebnisse des Screenings auf psychische Komorbiditäten bei Jugendlichen und jungen Erwachsenen im Rahmen des COACH-Konsortiums
    Georg Thieme Verlag KG ; 2022
    In:  Diabetologie und Stoffwechsel Vol. 17, No. 03 ( 2022-06), p. 197-207
    Details
    In: Diabetologie und Stoffwechsel, Georg Thieme Verlag KG, Vol. 17, No. 03 ( 2022-06), p. 197-207
    Abstract: Die interdisziplinäre Forschungskooperation COACH-Konsortium (Chronic Conditions in Adolescents – Implementation and Evaluation of Patient-centered Collaborative Healthcare) untersucht die psychosoziale Situation von Jugendlichen und jungen Erwachsenen mit chronischen körperlichen Erkrankungen. Zur Untersuchung der psychischen Komorbidität wurden bisher 1.023 Patienten mit Diabetes mellitus Typ 1 im Alter von 12–21 Jahren bei Routinevorstellungen in der Klinik bzw. Ambulanz mittels der Screening-Fragebogen Patient Health Questionnaire (PHQ-9) und Generalized Anxiety Disorder Scale-7 (GAD-7) zu Angst- und Depressionssymptomen befragt. 29,8 % der Jugendlichen und jungen Erwachsenen zeigten ein auffälliges Screening-Ergebnis. Dabei wurden 17,8 % der Fragebogen zu Angstsymptomen und 25,6 % der Fragebogen zu Depressionssymptomen auffällig mit Gesamtscore-Werten ≥ 7 in GAD-7 bzw. PHQ-9 beantwortet. Patienten mit erhöhten Depressions- und Angstwerten wiesen im Mittel einen deutlich höheren medianen HbA1c-Wert als Zeichen einer schlechteren Stoffwechseleinstellung auf (8,33 [8,09; 8,56]) als Patienten mit unauffälligem Screening (7,58 [7,48; 7,68] ; p  〈  0,0001). Angesichts der hohen Prävalenz auffälliger Depressions- und Angstwerte und der Assoziation mit höheren HbA1c-Werten sollte bei allen Jugendlichen mit Diabetes mellitus Typ 1 regelmäßig das Vorliegen psychischer Belastungen abgeklärt werden. Dies könnte eine frühzeitige Diagnose einer psychischen Komorbidität und Intervention ermöglichen. Auf der Basis der Studien im COACH-Projekt können nun evidenzbasierte Empfehlungen für die interdisziplinäre Gesundheitsversorgung von Jugendlichen mit chronischen körperlichen Erkrankungen erstellt werden, die die psychischen Komorbiditäten systematisch berücksichtigen.
    Type of Medium: Online Resource
    ISSN: 1861-9002 , 1861-9010
    URL: Article
    DOI: 10.1055/a-1589-7922
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
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  • 6
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    Common procedures and conditions leading to inpatient hospital admissions in adults with and without diabetes from 2015 to 2019 in Germany : A comparison of frequency, length of hospital stay and complications
    Springer Science and Business Media LLC ; 2023
    In:  Wiener klinische Wochenschrift Vol. 135, No. 13-14 ( 2023-07), p. 325-335
    Details
    In: Wiener klinische Wochenschrift, Springer Science and Business Media LLC, Vol. 135, No. 13-14 ( 2023-07), p. 325-335
    Abstract: To evaluate common surgical procedures and admission causes in inpatient cases with diabetes in Germany between 2015 and 2019 and compare them to inpatient cases without diabetes. Methods Based on the German diagnosis-related groups (G-DRG) statistics, regression models stratified by age groups and gender were used to calculate hospital admissions/100,000 individuals, hospital days as well as the proportion of complications and mortality in inpatient cases ≥ 40 years with or without a documented diagnosis of diabetes (type 1 or type 2). Results A total of 14,222,326 (21%) of all inpatient cases aged ≥ 40 years had a diagnosis of diabetes. More middle-aged females with vs. without diabetes/100,000 individuals [95% CI] were observed, most pronounced in cases aged 40– 〈  50 years with myocardial infarction (305 [293–319] vs. 36 [36–37] , p   〈  0.001). Higher proportions of complications and longer hospital stays were found for all procedures and morbidities in cases with diabetes. Conclusion Earlier hospitalizations, longer hospital stays and more complications in inpatient cases with diabetes together with the predicted future increase in diabetes prevalence depict huge challenges for the German healthcare system. There is an urgent need for developing strategies to adequately care for patients with diabetes in hospital.
    Type of Medium: Online Resource
    ISSN: 0043-5325 , 1613-7671
    URL: Article
    DOI: 10.1007/s00508-023-02153-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2244243-1
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  • 7
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    Exploration of Perceived Determinants of Disordered Eating Behaviors in People with Mental Illness—A Qualitative Study
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 1 ( 2022-12-27), p. 442-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 1 ( 2022-12-27), p. 442-
    Abstract: Disordered eating behaviors are common in people with a serious mental illness (SMI) such as schizophrenia, bipolar disorder and major depressive disorder. This study employed qualitative exploration to understand the perceived determinants of eating behaviors, in particular those connected to disordered eating patterns, in people with SMI. In total, 28 semi-structured interviews were conducted in a consecutive sample of people with SMI under treatment in local mental health services in Australia (n = 12), Germany (n = 8) and Austria (n = 8) (mean age: 43.3 years, proportion of female participants: 61%, proportion of participants with ICD-10 F2 diagnosis: 57%, proportion of participants with ICD-10 F3 diagnosis: 64%). A thematic analysis approach, the framework method, was applied using MAXQDA 2020. Three main themes of determinants were derived: (i) impacts to daily functioning, (ii) disrupted physical hunger cues and (iii) emotional hunger. For impacts to daily functioning, the following themes emerged: lack of daily structure, time and drive, and difficulty planning ahead. For physical hunger, themes emerged for disrupted hunger and satiety cues, and mindless eating. All motives listed in the Palatable Eating Motives Scale (PEMS), i.e., coping, reward, social and conformity, have been reported by participants to be drivers for their emotional eating behavior. Subsequent reported behaviors were eating too much or too little, binge eating, night eating and food cravings. We conclude that interprofessional approaches should target daily functioning, disrupted physical hunger cues and emotional eating to reduce disordered eating behaviors in people with SMI.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20010442
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 8
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    Good practice recommendations on implementation evaluation for policies targeting diet, physical activity, and sedentary behaviour
    Springer Science and Business Media LLC ; 2023
    In:  BMC Public Health Vol. 23, No. 1 ( 2023-06-28)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-06-28)
    Abstract: Health policies aim to achieve specific health goals through system-level changes, unlike common health interventions that focus on promoting specific health behaviors on individual level. However, reliable data on the feasibility and implementation of policy actions across Europe are lacking. Moreover, no practice-oriented guidance exists for policy makers and implementers on how to evaluate policy implementation. As part of the Policy Evaluation Network, we aimed to synthesise knowledge on how to evaluate the implementation of policies promoting healthy diets, physical activity, and reducing sedentary behaviours. The multidisciplinary working group comprised 16 researchers and conducted two scoping reviews, three systematic reviews, two meta-reviews, two qualitative case studies and one quantitative case study over three years. The target populations included the general population, those at risk for obesity, and school children. Based on these reviews and case studies, this article summarises and presents the findings and lessons learned regarding the implementation evaluation of policies in nine case reports. Drawing on these experiences, three critical requirements for policy implementation evaluation were set: 1) conduct a comprehensive policy implementation evaluation from a multi-level perspective, 2) use implementation frameworks to address processes, determinants, and outcomes, and 3) engage relevant stakeholders in policy implementation evaluation. Finally, the consensus process resulted in 10 steps for the implementation evaluation of policies to promote physical activity and a healthy diet and to reduce sedentary behaviours, which adhere to the requirements and resources of the targeted policy. The findings of an implementation evaluation can lead to a better understanding of why policies work or not and can serve as a basis for developing solutions. This practice-oriented guidance outlines factors that should be considered in policy implementation evaluation to address its complexity. In this way, involved researchers and practitioners are empowered to engage in the evaluation process to close the knowledge gap regarding policy implementation.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-023-15775-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041338-5
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  • 9
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    A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Pediatrics Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Pediatrics, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions. Methods/design We plan to consecutively recruit N  = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7  〈  7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey. Discussion The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation. Trial registration German Clinical Trials Register (DRKS), no. DRKS00025125 . Registered on May 17, 2021.
    Type of Medium: Online Resource
    ISSN: 1471-2431
    URL: Article
    DOI: 10.1186/s12887-021-02869-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041342-7
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  • 10
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    Advancing Implementation Science Measurement for Global Mental Health Research
    SAGE Publications ; 2022
    In:  The Canadian Journal of Psychiatry Vol. 67, No. 6 ( 2022-06), p. 428-431
    Details
    In: The Canadian Journal of Psychiatry, SAGE Publications, Vol. 67, No. 6 ( 2022-06), p. 428-431
    Type of Medium: Online Resource
    ISSN: 0706-7437 , 1497-0015
    URL: Article
    DOI: 10.1177/07067437221078411
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2035338-8
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