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Objective: The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.Methods: One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.Results: The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.Conclusions: For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis. [ABSTRACT FROM AUTHOR]

Background and Objectives: Internet-based interventions are a viable treatment option for various mental problems. However, their effects on the burnout syndrome yielded mixed results. In this paper, we examine the efficacy of a structured and therapist-guided internet intervention, based on solution-focused and cognitive-behavioral therapy, for individuals with symptoms of burnout.Design: Two-arm, Internet-based, randomized, wait-list controlled trial (RCT).Methods: Participants were recruited through in-house events and online advertising. They were randomly assigned to the intervention or a wait-list. Group comparison was conducted three months after randomization. Outcomes were the burnout level according to the Maslach Burnout Inventory (MBI-GS) and the levels of depression, anxiety and stress according to the DASS-21.Results: Thirty-nine participants were included in the trial; 36 (92.3%) took part at the 3-months-follow-up. Intention-to-treat analyses revealed significant group differences in favor of the intervention group in depression (d = 0.66), cynicism (d = 0.87) and personal accomplishment (d = 0.75).Conclusions: The intervention helped ameliorate symptoms of work-related stress and burnout. Although limited by a small sample size, the study suggests that the program provides effective support for affected individuals. However, further studies with bigger sample sizes should be conducted to examine the effects of such programs more precisely. [ABSTRACT FROM AUTHOR]

Background: The desire to have children has been declining globally, especially in industrialized nations. This study examines the physical health correlates, and positive and negative mental health correlates of the wish to have a child across time and in two countries.Method: Questionnaire data were obtained from large-scale university samples of 12,574 participants in Germany and China.Results: The wish to have a child (child wish) is related to positive and negative mental health in China and, to a lesser degree, in Germany. Child wish is positively related to some aspects of mental and somatic health for Chinese women and men, negatively to depression for Chinese and German men and Chinese women, and positively to stress for German men, with generally small effects. Effects hold when controlling for age, partnership status, and family affluence. Most relationships were almost equal between women and men (in both China and Germany), and between countries with the exception of two different paths in each gender group. That is, having a partner is associated with a higher child wish in both Chinese and German female students. In China, older female students are more likely to want to have a child, while older female students in Germany are less likely to want to have a child. Neither partnership nor age predict child wish for the next year.Conclusion: In sum, Chinese students reported feeling more positively about having children when they were happy and healthy, with the exception that highly satisfied Chinese males report lower child wish in the next year. More depressed Chinese and German men and Chinese women reported lowered child wish, and stressed German men reported more child wish. Older students reported more (Chinese) or less (German) child wish depending on country. [ABSTRACT FROM AUTHOR]

The aim of the study was to explore whether abstinent patients on recent opioid detoxification or on opioid maintenance treatment suffer from sleeping problems. 199 patients on opioid maintenance treatment (methadone, diacetylmorphine and buprenorphine) or recent opioid detoxification were included in this exploratory cross-sectional study. We used the Pittsburgh Sleep Quality Index (PSQI) and the Regensburger Insomnia Scale (RIS) in order to assess potential sleeping problems. There was a significant effect of the condition "opioid maintenance" or "recent opioid detoxification" on the total score of PSQI and RIS. All opioid maintenance drugs used by the study population were associated with more sleeping problems compared to the detoxification group when calculated with RIS values. Recently abstinent patients (opioid detoxification) displayed significantly fewer sleep disturbances than opioid-maintained patients. Since sleeping problems can seriously impair treatment success and quality of life, screening for sleep disturbances and their subsequent treatment is of pronounced relevance. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to provide insights into the impact of organizational family-centered care characteristics at German neonatal intensive care units (NICUs) on the satisfaction of parents of very low birthweight (VLBW) infants.Materials and methods: Using multilevel modeling, this study analyzed whether organizational characteristics of NICUs fostering parent-infant interaction (by way of the existence of a recreation room, possibility of rooming in, existence of unrestricted visiting hours for parents, existence of parental classes, and the connection to parent associations as well as the existence of standards on developmentally supportive care) increase the satisfaction of parents after the infants' high-intensive care phase within the NICU.Results: Nine hundred and twenty-three VLBW infants from 66 NICUs in Germany born between May and October 2013 were enrolled in this multicenter study. We retrieved 1493 questionnaires completed by 1277 parents. The existence of unrestricted visiting hours (adjusted odds ratio (AOR): 1.967; 95% CI [1.118, 3.459]) and standardized procedures for developmentally supportive care (AOR: 1.775; 95% CI [1.166, 2.704]) were positively associated with parental satisfaction.Conclusions: Fostering the parent-infant interaction through the provision of developmentally supportive care and unrestricted visiting hours for parents whose infants are hospitalized within an NICU significantly contributes to the satisfaction of parents. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to explore the evolution footprints of simulated driving research in the past 20 years through rigorous and systematic bibliometric analysis, to provide insights regarding when and where the research was performed and by whom and how the mainstream content evolved over the years.Methods: The analysis began with data retrieval in Web of Science with defined search terms related to simulated driving. BibExcel and CiteSpace were employed to conduct the performance analysis and co-citation network analysis; that is, probe of the performance of institutes, journals, authors, and research hotspots.Results: A total of 3,766 documents were filtered out and presented an exponential growth from 1997 to 2016. The United States contributed the most publications as well as international collaborations followed by Germany and China. In addition, several universities in The Netherlands and the United States dominated the list of contributing institutes. The leading journals were in transportation and ergonomics. The leading researchers were also recognized among the 8,721 contributing authors, such as J. D. Lee, D. L. Fisher, J. H. Kim, and K. A. Brookhuis. Finally, the co-citation analysis illuminated the evolution of simulated driving research that covered the following topics roughly in chronological order: task-induced stress, drivers with neurological disorders, alertness and sleepiness while driving, trust toward driving assistance systems, driver distraction, the effect of drug use, the validity of simulators, and automated driving.Conclusions: This article employed bibliometric tools to probe the contributing countries, institutes, journals, authors, and mainstream hotspots of simulated driving research in the past 20 years. A systematic bibliometric analysis of this field will help researchers realize the panorama of global simulated driving and establish future research directions. [ABSTRACT FROM AUTHOR]

Purpose:New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. Method:We evaluated components of the therapeutic intervention, from the patients’ and the therapists’ points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. Results:The results showed that the combination and application of theBerlin Protocol for Mirror Therapytogether with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Conclusions:Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for RehabilitationComputerised Mirror Therapy is feasible for clinical useAugmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient settingVirtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation [ABSTRACT FROM PUBLISHER]

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Objectives: Determination of the ovulation inhibition efficacy of a new, transparent, transdermal, combined hormonal contraceptive patch (area 10 cm2) containing 0.9 mg ethinylestradiol and 1.9 mg gestodene in an open-label study of healthy, female volunteers (aged 18-35 years).Methods: A total of 199 volunteers from two centers were requested to use the contraceptive patch (one patch/week for 3 weeks, followed by 1 week of no treatment), throughout two menstrual cycles. Ovarian activity was monitored by transvaginal ultrasonography and serum hormone determinations, and classified according to the Hoogland score.Results: Ovulation inhibition was achieved in all participants (Hoogland score < 6). Secondary efficacy measures, including suppression of serum concentrations of estradiol and progesterone, and of the mid-cycle luteinizing hormone surge, confirmed ovulation inhibition. Ovulation returned in 85.7% of participants during the first cycle after cessation of treatment. There were no abnormal changes in safety parameters. A large majority of users rated the contraceptive patch as 'very convenient'.Conclusions: This study showed that the new, combined ethinylestradiol/gestodene contraceptive patch was highly effective in reversibly inhibiting ovulation, well tolerated and regarded as 'very convenient' by the majority of users. This new, transparent, transdermal matrix patch is an attractive alternative form of contraception. [ABSTRACT FROM AUTHOR]