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Background: Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that symptoms may be reduced by interventions in the workplace. This paper is the first to systematically review psychosocial interventions for depression, anxiety, and suicidal ideation and behaviours in small-to medium-size enterprises (SMEs).
Methods: A systematic search following PRISMA guidelines, registered in PROSPERO (CRD42020156275), was conducted for psychosocial interventions targeting depression, anxiety, and suicidal ideation/behaviour in SMEs. The PubMed, PsycINFO, Scopus, and two specific occupational health databases were searched, as well as four databases for grey literature, without time limit until 2nd December 2019.
Results: In total, 1283 records were identified, 70 were retained for full-text screening, and seven met the inclusion criteria: three randomised controlled trials (RCTs), three before and after designs and one non-randomised trial, comprising 5111 participants. Study quality was low to moderate according to the Quality Assessment Tool for Quantitative Studies. Five studies showed a reduction in depression and anxiety symptoms using techniques based on cognitive behavioural therapy (CBT), two reported no significant change.
Limitations: Low number and high heterogeneity of interventions and outcomes, high attrition and lack of rigorous RCTs.
Conclusions: Preliminary evidence indicates CBT-based interventions can be effective in targeting symptoms of depression and anxiety in SME employees. There may be unique challenges to implementing programmes in SMEs. Further research is needed in this important area.
WiWi news [1/2021]
(2021)
Background: Using data from the COHERE collaboration, we investigated whether primary prophylaxis for pneumocystis pneumonia (PcP) might be withheld in all patients on antiretroviral therapy (ART) with suppressed plasma human immunodeficiency virus (HIV) RNA (≤400 copies/mL), irrespective of CD4 count.
Methods: We implemented an established causal inference approach whereby observational data are used to emulate a randomized trial. Patients taking PcP prophylaxis were eligible for the emulated trial if their CD4 count was ≤200 cells/µL in line with existing recommendations. We compared the following 2 strategies for stopping prophylaxis: (1) when CD4 count was >200 cells/µL for >3 months or (2) when the patient was virologically suppressed (2 consecutive HIV RNA ≤400 copies/mL). Patients were artificially censored if they did not comply with these stopping rules. We estimated the risk of primary PcP in patients on ART, using the hazard ratio (HR) to compare the stopping strategies by fitting a pooled logistic model, including inverse probability weights to adjust for the selection bias introduced by the artificial censoring.
Results: A total of 4813 patients (10 324 person-years) complied with eligibility conditions for the emulated trial. With primary PcP diagnosis as an endpoint, the adjusted HR (aHR) indicated a slightly lower, but not statistically significant, different risk for the strategy based on viral suppression alone compared with the existing guidelines (aHR, .8; 95% confidence interval, .6–1.1; P = .2).
Conclusions: This study suggests that primary PcP prophylaxis might be safely withheld in confirmed virologically suppressed patients on ART, regardless of their CD4 count.
In Kindertageseinrichtungen und Schulen wird dem pädagogischen Personal in Bezug auf Sprachförderung ein hoher Qualifizierungsbedarf attestiert; zugleich gibt es wenig gesichertes empirisches Wissen über die Wirkungen entsprechender Fortbildungen. Das Fortbildungsangebot und die Teilnehmenden sind heterogen. Um die Heterogenität der Teilnehmenden zu entschlüsseln, wurden im BiSS-Evaluationsprojekt „SPRÜNGE“ (Sprachförderung im Übergang Kindergarten – Grundschule evaluieren) auf Grundlage einer Typenbildung von N = 27 Fach- und Lehrkräften Unterschiede in ihren Sprachförderkompetenzen und im Fortbildungsbesuch empirisch-quantitativ mittels des Online-Tests SprachKoPF überprüft und für zwei Sprachfördertypen ihre handlungsleitenden Orientierungen in Bezug auf die Wirkungen von Fortbildungen rekonstruiert. Bei diesen beiden, stark fortgebildeten Sprachfördertypen konnten differenzierbare Deutungen zu den Wirkungen von Fortbildungen herausgearbeitet werden, wobei einerseits eine stärkere Kita-Orientierung und andererseits eine stärkere Schulorientierung als (implizite) Referenz deutlich wird. Zudem ließen sich Gelingensbedingungen von Fortbildungen wie „Praxisrelevanz“, die als allgemeingültig angenommen werden, typenspezifisch ausdifferenzieren. Mit der multiperspektivischen Untersuchung der differentiellen Wirkungen von Fortbildungen leistet das Projekt einen explorativen Beitrag zu einer quantitativ und qualitativ ausgerichteten Wirkungsforschung am Übergang Kita-Grundschule.
The formation of amyloid-β oligomers plays a key role in the onset of Alzheimer’s disease. We investigated the aggregation of amyloid-β oligomers by mass spectrometry and ion mobility spectrometry, revealing those structural properties, which lead to the formation of mature fibrils. We can show that the arrangement of the first oligomers is crucial for the topology of the resulting species, leading to the formation of non-toxic aggregates or fibrils.
In this article, I question the use of the notion of ‘constituent power’ as a tool for the democratization of the European Union (EU). Rather than seeing the absence of a transnational constituent power as a cause of the EU’s ‘democratic deficit’, I identify it as an opportunity for unfettered democratic participation. Against the reification of power-in-action into a power-constituted-in-law, I argue that the democratization of the EU can only be achieved through the multiplication of ‘constituent moments’. I begin by deconstructing the normative justifications surrounding the concept of constituent power. Here I analyze the structural aporia of constituent power and question the autonomous and emancipatory dimension of this notion. I then test the theoretical hypothesis of this structural aporia of the popular constituent power by comparing it with the historical experiments of a European popular constituent power. Finally, based on these theoretical and empirical observations, I propose to replace the ambivalence of the concept of popular constituent power with a more cautious approach to the bottom-up democratization of European integration: that of a multiplication of transnational constituent moments.
It is increasingly recognized that neuroscience has not delivered the revolutionary clinical possibilities for psychiatry that had been promised. Explanations differ, however: some proponents emphasize the divide between biopsychosocial psychiatry and mechanistic neurology. Others rely on further basic experimental neuroscience as only the most elementary level of explanation will allow us to fully understand and treat mental disorders. From a clinical-neuropsychological perspective, I shall argue that both views are mistaken. Diagnosis and treatment of neurological diseases demands a biopsychosocial perspective similar to psychiatry. Acknowledging this might help to bring both disciplines together and improve clinical outcome.
Species is the fundamental taxonomic unit in biology and its delimitation has implications for conservation. In giraffe (Giraffa spp.), multiple taxonomic classifications have been proposed since the early 1900s.1 However, one species with nine subspecies has been generally accepted,2 likely due to limited in-depth assessments, subspecies hybridizing in captivity,3,4 and anecdotal reports of hybrids in the wild.5 Giraffe taxonomy received new attention after population genetic studies using traditional genetic markers suggested at least four species.6,7 This view has been met with controversy,8 setting the stage for debate.9,10 Genomics is significantly enhancing our understanding of biodiversity and speciation relative to traditional genetic approaches and thus has important implications for species delineation and conservation.11 We present a high-quality de novo genome assembly of the critically endangered Kordofan giraffe (G. camelopardalis antiquorum)12 and a comprehensive whole-genome analysis of 50 giraffe representing all traditionally recognized subspecies. Population structure and phylogenomic analyses support four separately evolving giraffe lineages, which diverged 230–370 ka ago. These lineages underwent distinct demographic histories and show different levels of heterozygosity and inbreeding. Our results strengthen previous findings of limited gene flow and admixture among putative giraffe species6,7,9 and establish a genomic foundation for recognizing four species and seven subspecies, the latter of which should be considered as evolutionary significant units. Achieving a consensus over the number of species and subspecies in giraffe is essential for adequately assessing their threat level and will improve conservation efforts for these iconic taxa.
We consider an additively time-separable life-cycle model for the family of power period utility functions u such that u0(c) = c−θ for resistance to inter-temporal substitution of θ > 0. The utility maximization problem over life-time consumption is dynamically inconsistent for almost all specifications of effective discount factors. Pollak (1968) shows that the savings behavior of a sophisticated agent and her naive counterpart is always identical for a logarithmic utility function (i.e., for θ = 1). As an extension of Pollak’s result we show that the sophisticated agent saves a greater (smaller) fraction of her wealth in every period than her naive counterpart whenever θ > 1 (θ < 1) irrespective of the specification of discount factors. We further show that this finding extends to an environment with risky returns and dynamically inconsistent Epstein-Zin-Weil preferences.
This paper uses a novel account of non-ideal political action that can justify radical responses to severe climate injustice, including and especially deliberate attempts to engineer the climate system in order reflect sunlight into space and cooling the planet. In particular, it discusses the question of what those suffering from climate injustice may do in order to secure their fundamental rights and interests in the face of severe climate change impacts. Using the example of risky geoengineering strategies such as sulfate aerosol injections, I argue that peoples that are innocently subject to severely negative climate change impacts may have a special permission to engage in large-scale yet risky climate interventions to prevent them. Furthermore, this can be true even if those interventions wrongly harm innocent people.
The future of work has become a pressing matter of concern: Researchers, business consultancies, and industrial companies are intensively studying how new work models could be best implemented to increase workplace flexibility and creativity. In particular, the agile model has become one of the “must-have” elements for re-organizing work practices, especially for technology development work. However, the implementation of agile work often comes together with strong presumptions: it is regarded as an inevitable tool that can be universally integrated into different workplaces while having the same outcome of flexibility, transparency, and flattened hierarchies everywhere. This paper challenges such essentializing assumptions by turning agile work into a “matter of care.” We argue that care work occurs in contexts other than feminized reproductive work, namely, technology development. Drawing on concepts from feminist Science and Technology Studies and ethnographic research at agile technology development workplaces in Germany and Kenya, we examine what work it takes to actually keep up with the imperative of agile work. The analysis brings the often invisibilized care practices of human and nonhuman actors to the fore that are necessary to enact and stabilize the agile promises of flexibilization, co-working, and rapid prototyping. Revealing the caring sociotechnical relationships that are vital for working agile, we discuss the emergence of power asymmetries characterized by hierarchies of skills that are differently acknowledged in the daily work of technology development. The paper ends by speculating on the emancipatory potential of a care perspective, by which we seek to inspire careful Emancipatory Technology Studies.
Background: Peanuts are a member of the legume family (botanical family Leguminosae) and peanut allergies are the most common cause of food anaphylaxis in many countries. The prevalence of peanut allergy is increasing.
Methods: Experts from Germany and Austria performed a standardized literature search and published their consensus recommendations in a White Paper on Peanut Allergy, which this care pathway is based upon, thus, providing a comprehensive diagnosis and treatment algorithm.
Results: The most important diagnostic key elements include a detailed clinical medical history, evidence of peanut-specific sensitization by means of skin prick testing and/or in vitro determination of the peanut (extract)-specific IgE and/or the molecular component diagnostics (most important Ara h 2-specific IgE, sometimes also Ara h1-, 3-, 6-, 8- and 9-specific IgE) as well as the gold standard, the double-blind, placebo-controlled food challenge. The diagnostic algorithms were created for the following constellations: Suspected primary peanut allergy with a clear history of systemic immediate-type reaction, suspected primary peanut allergy with questionable symptoms, suspected secondary (possibly pollen-associated) peanut allergy with a history of solely oropharyngeal symptoms and incidental finding of sensitization and no peanut ingestion so far.
Conclusions: After established diagnosis the standard of care is counseling to avoid peanut contact and prescription of emergency medications (oral antihistamines, oral steroids, inhaled β2-agonists, injectable intramuscular epinephrine) as needed. Instruction on the use of these emergency medications should be provided. A preparation for oral immunotherapy (OIT) for 4 to 17 years old peanut allergic children/ adolescents has been recently approved by the regulatory authorities. OIT for peanut allergy shows high efficacy and an acceptable safety profile, improves quality of life, and health economic aspects. Thus it offers a therapeutic option for peanut allergic children and adolescents.