TY - JOUR A1 - Hegerl, Ulrich A1 - Wittenburg, Lisa A1 - Arensman, Ella A1 - Van Audenhove, Chantal A1 - Coyne, James C. A1 - McDaid, David A1 - van der Feltz-Cornelis, Christina M. A1 - Gusmão, Ricardo A1 - Kopp, Mária A1 - Maxwell, Margaret A1 - Meise, Ullrich A1 - Roskar, Saska A1 - Sarchiapone, Marco A1 - Schmidtke, Armin A1 - Värnik, Airi A1 - Bramesfeld, Anke T1 - Optimizing Suicide Prevention Programs and Their Implementation in Europe (OSPI Europe): an evidence-based multi-level approach JF - BMC Public Health N2 - Background Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. Method The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. Discussion This multi-centre research seeks to overcome major challenges of field research in suicide prevention. It pools data from four European regions, considerably increasing the study sample, which will be close to one million. In addition, the study will gather important information concerning the potential to transfer this multilevel program to other health care systems. The results of this research will provide a basis for developing an evidence-based, efficient concept for suicide prevention for EU-member states. KW - suicide prevention KW - preventive strategies KW - Europe Y1 - 2009 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-154695 VL - 9 IS - 428 ER - TY - JOUR A1 - Voigt, Gesche M. A1 - Thiele, Dominik A1 - Wetzke, Martin A1 - Weidemann, Jürgen A1 - Parpatt, Patricia‐Maria A1 - Welte, Tobias A1 - Seidenberg, Jürgen A1 - Vogelberg, Christian A1 - Koster, Holger A1 - Rohde, Gernot G. U. A1 - Härtel, Christoph A1 - Hansen, Gesine A1 - Kopp, Matthias V. T1 - Interobserver agreement in interpretation of chest radiographs for pediatric community acquired pneumonia: Findings of the pedCAPNETZ‐cohort JF - Pediatric Pulmonology N2 - Although chest radiograph (CXR) is commonly used in diagnosing pediatric community acquired pneumonia (pCAP), limited data on interobserver agreement among radiologists exist. PedCAPNETZ is a prospective, observational, and multicenter study on pCAP. N = 233 CXR from patients with clinical diagnosis of pCAP were retrieved and n = 12 CXR without pathological findings were added. All CXR were interpreted by a radiologist at the site of recruitment and by two external, blinded pediatric radiologists. To evaluate interobserver agreement, the reporting of presence or absence of pCAP in CXR was analyzed, and prevalence and bias‐adjusted kappa (PABAK) statistical testing was applied. Overall, n = 190 (82%) of CXR were confirmed as pCAP by two external pediatric radiologists. Compared with patients with pCAP negative CXR, patients with CXR‐confirmed pCAP displayed higher C‐reactive protein levels and a longer duration of symptoms before enrollment (p < .007). Further parameters, that is, age, respiratory rate, and oxygen saturation showed no significant difference. The interobserver agreement between the onsite radiologists and each of the two independent pediatric radiologists for the presence of pCAP was poor to fair (69%; PABAK = 0.39% and 76%; PABAK = 0.53, respectively). The concordance between the external radiologists was fair (81%; PABAK = 0.62). With regard to typical CXR findings for pCAP, chance corrected interrater agreement was highest for pleural effusions, infiltrates, and consolidations and lowest for interstitial patterns and peribronchial thickening. Our data show a poor interobserver agreement in the CXR‐based diagnosis of pCAP and emphasized the need for harmonized interpretation standards. KW - antibiotic therapy KW - imaging KW - infections: pneumonia KW - TB KW - viral Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244705 VL - 56 IS - 8 SP - 2676 EP - 2685 ER -