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Purpose: Risk scores for community-acquired pneumonia (CAP) are widely used for standardized assessment in immunocompetent patients and to identify patients at risk for severe pneumonia and death. In immunocompromised patients, the prognostic value of pneumonia-specific risk scores seems to be reduced, but evidence is limited. The value of different pneumonia risk scores in kidney transplant recipients (KTR) is not known. Methods: Therefore, we retrospectively analyzed 310 first CAP episodes after kidney transplantation in 310 KTR. We assessed clinical outcomes and validated eight different risk scores (CRB-65, CURB-65, DS-CRB-65, qSOFA, SOFA, PSI, IDSA/ATS minor criteria, NEWS-2) for the prognosis of severe pneumonia and in-hospital mortality. Risk scores were assessed up to 48 h after admission, but always before an endpoint occurred. Multiple imputation was performed to handle missing values. Results: In total, 16 out of 310 patients (5.2%) died, and 48 (15.5%) developed severe pneumonia. Based on ROC analysis, sequential organ failure assessment (SOFA) and national early warning score 2 (NEWS-2) performed best, predicting severe pneumonia with AUC of 0.823 (0.747–0.880) and 0.784 (0.691–0.855), respectively. Conclusion: SOFA and NEWS-2 are best suited to identify KTR at risk for the development of severe CAP. In contrast to immunocompetent patients, CRB-65 should not be used to guide outpatient treatment in KTR, since there is a 7% risk for the development of severe pneumonia even in patients with a score of zero. [ABSTRACT FROM AUTHOR]

The current study tested whether the reported lower wellbeing of parents after preterm birth, relative to term birth, is a continuation of a pre-existing difference before pregnancy. Parents from Germany (the German Socio-Economic Panel Study, N = 10,649) and the United Kingdom (British Household Panel Study and Understanding Society, N = 11,012) reported their new-born's birthweight and gestational age, subsequently categorised as very preterm or very low birthweight (VP/VLBW, < 32 weeks or < 1500 g), moderately/late preterm or low birthweight (MLP/LBW, ≥ 32 weeks and < 37 weeks/≥ 1500 g and < 2500 g), or term-born (≥ 37 weeks and ≥ 2500 g). Mixed models were used to analyse life satisfaction, an aspect of wellbeing, at four assessments-two years and six months before birth and six months and two years afterwards. Two years before birth, satisfaction of prospective term-born, MLP/LBW, or VP/VLBW mothers did not significantly differ. However, mothers of VP/VLBWs had lower satisfaction relative to mothers of term-borns at both assessments post-birth. Among fathers, satisfaction levels were similarly equivalent two years before birth. Subsequently, fathers of VP/VLBWs temporarily differed in satisfaction six months post-birth relative to fathers of term-borns. Results indicate that parents' lower life satisfaction after VP/VLBW birth is not a continuation of pre-existing life satisfaction differences. [ABSTRACT FROM AUTHOR]

Background: Regulatory problems (RPs; excessive crying, sleeping, or feeding difficulties) that co‐occur (i.e., multiple) or are persistent have been associated with cognitive and behavioral problems in childhood. However, it remains unknown if multiple or persistent RPs are associated with cognitive and behavioral problems in adulthood. Methods: This large prospective longitudinal study (N = 759) was conducted in two cohorts in Germany (N = 342) and Finland (N = 417). RPs were assessed at 5, 20, and 56 months via the same standardized parental interviews and neurological examinations. In young adulthood, questionnaires were used to assess behavioral problems. Cognitive functioning was assessed with IQ tests. We examined the effects of multiple or persistent RPs on the outcomes via analysis of covariance tests and logistic regression controlled for the influence of cohort. Results: Of 163 participants with RPs, 89 had multiple and 77 had persistent RPs. Adults who had early multiple or persistent RPs (N = 151) reported more internalizing (p =.001), externalizing (p =.020), and total behavioral problems (p =.001), and, specifically, more depressive (p =.012), somatic (p =.005), avoidant personality (p <.001), and antisocial personality problems (p =.006) than those who never had RPs (N = 596). Participants with multiple or persistent RPs were more likely to receive any ADHD diagnoses (p =.017), particularly of hyperactive/impulsive subtype (p =.032). In contrast, there were no associations between multiple or persistent RPs and IQ scores in young adulthood. Conclusions: The results indicate long‐lasting associations between multiple or persistent RPs and behavioral problems. Thus, screening for early RPs could help to identify children who are at risk for later behavioral problems. [ABSTRACT FROM AUTHOR]

Background: Multiple or persistent crying, sleeping, or feeding problems in early childhood (regulatory problems) are associated with increased internalizing symptoms in adulthood. Unknown is whether early regulatory problems are associated with emotional disorders in adulthood, and what psychosocial factors may provide protection. We tested whether early childhood multiple or persistent regulatory problems are associated with a higher risk of (a) any mood and anxiety disorder in adulthood; (b) perceiving no social support in adulthood; and (c) whether social support provides protection from mood and anxiety disorders among participants who had multiple/persistent regulatory problems and those who never had regulatory problems. Methods: Data from two prospective longitudinal studies in Germany (n = 297) and Finland (n = 342) was included (N = 639). Regulatory problems were assessed at 5, 20, and 56 months with the same standardized parental interviews and neurological examinations. In adulthood (24–30 years), emotional disorders were assessed with diagnostic interviews and social support with questionnaires. Results: Children with multiple/persistent regulatory problems (n = 132) had a higher risk of any mood disorder (odds ratio (OR) = 1.81 [95% confidence interval = 1.01–3.23]) and of not having any social support from peers and friends (OR = 1.67 [1.07–2.58]) in adulthood than children who never had regulatory problems. Social support from peers and friends provided protection from mood disorders, but only among adults who never had regulatory problems (OR = 4.03 [2.16–7.94]; p =.039 for regulatory problems x social support interaction). Conclusions: Children with multiple/persistent regulatory problems are at increased risk of mood disorders in young adulthood. Social support from peers and friends may, however, only provide protection from mood disorders in individuals who never had regulatory problems. [ABSTRACT FROM AUTHOR]

Background: The majority of severely ill and dying people in Germany can be administered primary palliative care (PPC) by general practitioners (GP). However, the current provision of PPC does not match the needs of the population. Although several public health strategies aim at strengthening the role of GPs in PPC provision, it remains challenging for GP teams to integrate PPC into their daily routines. Aim: A Delphi study with GPs was conducted to achieve consensus on specific measures for improving the integration of PPC into everyday GP practice. Methods: The study is part of the junior research project "Primary Palliative Care in General Practice" (ALLPRAX). After having developed, tested and evaluated 26 practical measures for GP practices to improve their PPC, a Delphi consensus study among GPs took place. In 2020, 569 GPs were asked to rate the relevance and feasibility of the measures on a 4-point Likert scale via an anonymous online questionnaire. Consensus was defined as a sum percentage of 'strongly agree' and 'somewhat agree' responses ≥75% after two rounds. Between these rounds, measures that were not consented in the first round were adapted in light of respondents' free text comments and suggestions. Results: The response rate was 11.3% in round 1 (n = 64) and 53.1% in round 2 (n = 34). From the initial n = 26 measures, n = 20 measures achieved consensus and were included in the final intervention package. The consented measures pertained to four main topics: advance care planning with patients, consulting and informing patients and family caregivers, GP office organisation and continuing education. N = 6 measures did not achieve consensus, predominantly due to time and workload constraints. Conclusion: The consented measures provide valuable support to improve the provision of PPC by GPs. They can be used freely and flexibly, according to the needs of individual GP teams, and are thus suitable for implementation nationwide. Trial registration: The study was registered in the German Clinical Trials Register (Registration N° DRKS00011821; 4 December 2017; https://apps.who.int/trialsearch/) and the German Register of Health Care Research (Registration N° VfD_ALLPRAX_16_003817; 30 March 2017). [ABSTRACT FROM AUTHOR]

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This research was conducted at the breeding station of the Turkish breeding company Agromar A.Ş in the city of Bursa in Turkey during the 2013 and 2014 growing seasons. Used from within the same heterotic group crossings, 7 donor materials were obtained during the 2012 winter season in the greenhouse. The inducer line RWK-76xRWS, provided by University of Hohenheim, Germany, was used for generating haploid seeds. The donor and inducer crossing was performed during the 2013 summer season. The haploid selection and chromosome doubling were performed during the 2014 summer season. Seven donors were used for haploid induction which name are DNR1, DNR2, DNR3, DNR4, DNR5, DNR6, DNR7 respectively, from each donor different amount of ear crosses were performed (DNR1:16 ears, DNR2:10 ears, DNR3:10 ears, DNR4:12 ears, DNR5:11 ears, DNR6:13 ears, DNR7:11 ears). According to the present study, the average induction rate found ranged from 7.1 to 12.8%, and the average seedling survival rate in the greenhouse after colchicine application ranged from 57.9 to 77.6%. After transplanting to the field, 78.3-92.6% of these plants survived. As a result of this research, the chromosome doubling rate ranged from 22.5 to 48.3% depending on the donor material. These result indicates that maternal haploid selection visually is easy. Haploid induction rate (HIR) changes from donor to donor, its mean genotype and environment is effective for HIR. Average chromosome doubling rate is lower than other researchers' results, it is also effected by genotype and chromosome doubling methods. [ABSTRACT FROM AUTHOR]

Values are important factors in determining individuals' behaviours. Previous studies have examined the relations between values and helping behaviour, but usually in the context of a single culture. The current study examines the relations between personal value types and helping behaviour among university students ( N = 722) in four cultures (Germany, Scotland-UK, Israel and Turkey). Across cultures, the value types of self-transcendence versus self-enhancement and conservation versus openness to change were positively related to helping. Specifically, self-transcendence values were positively related, and self-enhancement and openness to change values negatively related, to helping behaviour. The correlations pattern did not differ significantly between cultures. [ABSTRACT FROM AUTHOR]

Objective: To study self-reported well-being and self-esteem among adolescents born very preterm (VPT; <32 wk of gestation) and moderate to late preterm (MLPT; 32-36 wk of gestation) compared with those born full-term (FT) in an individual participant data (IPD) meta-analysis., Methods: We obtained IPD from the following 4 data sources: The Avon Longitudinal Study of Parents and Children (United Kingdom), the Millennium Cohort Study (United Kingdom), the Basel Study of Preterm Children (Switzerland), and the Bavarian Longitudinal Study (Germany) and conducted two-step random-effects IPD meta-analysis. A total of 986 MLPT, 412 VPT, and 12,719 FT born adolescents reported on subjective well-being and 927 MLPT, 175 VPT, and 13,312 FT born adolescents reported on global self-esteem., Results: Adolescents born VPT or MLPT were not different from those born FT regarding general subjective well-being; family, school, and physical appearance-related well-being; and global self-esteem. However, adolescents born VPT reported lower well-being in peer relationships than those born FT (β = -0.209, 95% confidence interval = -0.336 to -0.082). There was no main effect of fetal growth restriction (FGR) and no moderation by FGR, sex, parental education, and ethnicity. No significant heterogeneity between cohorts was found, although some heterogeneity estimates were moderate., Conclusion: Adolescents born preterm mostly report no lower well-being and self-esteem than adolescents born FT. However, they perceive their peer relationships as poorer than those born FT., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)