Brustkrebs ist mit weltweit fast 2 Millionen Neuerkrankungen jährlich (Stand 2020) das am häufigsten diagnostizierte Malignom bei Frauen im gebärfähigen Alter. Patientinnen im jugendlichen und jungen Erwachsenenalter (AYA) sind hierbei oft mit sexualitätsbezogenen Problemen konfrontiert, die nur selten in der onkologischen Routineversorgung angesprochen werden und wenig Beachtung finden. In der vorliegenden Studie wurden 139 Brustkrebspatientinnen im Alter von 18 bis 39 Jahre zu zwei verschiedenen Zeitpunkten mit einem Abstand von einem Jahr über die Zufriedenheit und den Unterstützungs-bedarf in den Bereichen der Sexualität, Fertilität, Familienplanung, Familienleben und Partnerschaft befragt. Ziel unserer Studie war es, anhand der Einschätzung der Veränderungen in den verschiedenen Bereichen Daten bereitzustellen, die dazu genutzt werden können, die multimodale, interdisziplinäre Betreuung der Betroffenen in medizinischer und psychosozialer Sicht auf die Bedürfnisse der Patientinnen anzupassen und zu verbessern. Generell wurde festgestellt, dass ein geringes Level an Zufriedenheit mit hohem Unterstützungsbedarf einhergeht. Über unseren Beobachtungszeitraum von einem Jahr zeigten sich die Patientinnen eher zufrieden in den Bereichen Partnerschaft und Familienleben, während sie mit ihrer Sexualität und Familienplanung eher unzufrieden waren. Letzteres steht in engem Zusammenhang mit fertilitätserhaltenden Maßnahmen aufgrund der potentiell fruchtbarkeits-schädigenden Nebenwirkungen der onkologischen Therapie. Junge Betroffene sollten hier noch weit-reichender beraten und unterstützt werden. Besonders Frauen, deren Familienplanung noch nicht ab-geschlossen ist, benötigen vor Beginn der Behandlung aktiv Informationen und Unterstützungsbedarf.:Inhaltsverzeichnis 1. Abkürzungsverzeichis 4 2. Einleitung 5 2.1 Das Mammakarzinom 5 2.1.1 Epidemiologie 5 2.1.2 Ätiologie 6 2.1.3 Klinik des Mammakarzinoms 6 2.1.4 Lokalisation und Metastasierung 7 2.1.5 Diagnostik 8 2.1.6 Therapie 9 2.2 Das Leben mit Brustkrebs (physische, psychische und soziale Faktoren) 11 2.2.1 Lebensqualität bei Brustkrebspatientinnen 11 2.2.2 Krebs und Psyche 12 2.2.3 Krebs und Sexualität 13 2.2.4 Krebs und Fertilität 14 2.2.5 Sexualität und Partnerschaft 16 2.3 Forschungsfragen 18 2.4 Literaturverzeichnis 19 3. Publikation 24 4. Zusammenfassung 35 4.1 Einführung 35 4.2 Methodik 36 4.3 Ergebnisse 37 4.4 Diskussion 38 5. Anlagen 40 5.1 Spezifizierung des eigenen Beitrags 40 5.2 Erklärung über die eigenständige Abfassung der Arbeit 41 5.3 Danksagung 42

No / Survey results from 161 respondents trained in dementia care mapping (DCM) in the United States and United Kingdom (82 and 79 respondents, respectively) addressed the following: (a) To what extent are mappers using DCM? (b) How satisfied are mappers with DCM? (c) What affect does DCM have on mappers' attitudes toward their dementia practice? and (d) What challenges are encountered by mappers in the use of DCM? METHOD: Analyses using odds ratios were used to make international and training-level (basic vs. advanced) comparisons. RESULTS: Differences across countries were found in use of DCM and lack of satisfaction using DCM codes. Similarities were found with positive affects of DCM on attitudes and lack of time for DCM. DISCUSSION: Differences in mappers' experiences and perceptions exist across the two countries, warranting increased attention to the cultural contexts within which mappers are situated and how these affect the implementation of DCM within a country.

Yes / The frequency of visits to Emergency Departments (ED) varies greatly between populations. This may reflect variation in patient behaviour, need, accessibility, and service configuration as well as the complex interactions between these factors. This study investigates the relationship between distance, socio-economic deprivation, and proximity to an alternative care setting (a Minor Injuries Unit (MIU)), with particular attention to the interaction between distance and deprivation. It is set in a population of approximately 5.4 million living in central England, which is highly heterogeneous in terms of ethnicity, socio-economics, and distance to hospital. The study data set captured 1,413,363 ED visits made by residents of the region to National Health Service (NHS) hospitals during the financial year 2007/8. Our units of analysis were small units of census geography having an average population of 1,545. Separate regression models were made for children and adults. For each additional kilometre of distance from a hospital, predicted child attendances fell by 2.2% (1.7%-2.6% p<0.001) and predicted adult attendances fell by 1.5% (1.2% -1.8%, p<0.001). Compared to the least deprived quintile, attendances in the most deprived quintile more than doubled for children (incident rate ratio (IRR) = 2.19, (1.90-2.54, p<0.001)) and adults (IRR 2.26, (2.01-2.55, p<0.001)). Proximity of an MIU was significant and both adult and child attendances were greater in populations who lived further away from them, suggesting that MIUs may reduce ED demand. The interaction between distance and deprivation was significant. Attendance in deprived neighbourhoods reduces with distance to a greater degree than in less deprived ones for both adults and children. In conclusion, ED use is related to both deprivation and distance, but the effect of distance is modified by deprivation.

No / Area V3A was identified in five human subjects on both a functional and retinotopic basis using functional magnetic resonance imaging techniques. V3A, along with other visual areas responsive to motion, was then targeted for disruption by repetitive transcranial magnetic stimulation (rTMS) whilst the participants performed a delayed speed matching task. The stimuli used for this task included chromatic, isoluminant motion stimuli that activated either the L-M or S-(L+M) cone-opponent mechanisms, in addition to moving stimuli that contained only luminance contrast (L+M). The speed matching task was performed for chromatic and luminance stimuli that moved at slow (2 degrees/s) or faster (8 degrees/s) speeds. The application of rTMS to area V3A produced a perceived slowing of all chromatic and luminance stimuli at both slow and fast speeds. Similar deficits were found when rTMS was applied to V5/MT+. No deficits in performance were found when areas V3B and V3d were targeted by rTMS. These results provide evidence of a causal link between neural activity in human area V3A and the perception of chromatic isoluminant motion. They establish area V3A, alongside V5/MT+, as a key area in a cortical network that underpins the analysis of not only luminance but also chromatically-defined motion.

Yes / The NHS spends billions of pounds annually on repeat prescriptions in primary care, but data on their extent and use is out of date. Understanding the scale of repeat prescribing and for whom it is prescribed is important for the NHS to plan services and develop policies to improve patient care. Anonymous data on prescription numbers and practice population demographics was obtained from GP computer systems in a large urban area.Searches were conducted in November 2011 to identify the numbers of repeat items listed on individuals' repeat lists by sex and age.The proportion of all prescription items issued as repeats was identified by conducting searches on items issued as repeat and acute prescriptions. In the year of study 4,453,225 items were issued of which 3,444,769 (77%) were repeats (mean 13 items per patient/annum) and 1,008,456 (23%) acute prescriptions (mean 3.9 items per patient per annum). The mean number of repeat Items per patient was 1.87 (range 0.45 ages 0-9 years; 7.1 ages 80-89 years). At least one repeat medicine was prescribed to 43% of the population (range 20% for ages 0-9; over 75% for ages 60+). A significant proportion of the population receive repeat prescriptions and the proportion increases with age. Whilst the proportion of repeat items to acute items has remained unchanged over the last two decades the number of repeat prescriptions items issued has doubled (from 5.8 to 13.3 items/patient/annum). This has implications for general practice workload, patient convenience, NHS costs and risk.

This diploma thesis thematically follows up one of subgenres of young adult popular literature - paranormal romance. Its main aim is to create a comprehensive definition of this subgenre on the basis of interpretation of representative sagas - Twilight by Stephenie Meyer (Twilight, New Moon, Eclipse, Breaking Dawn), Hush, Hush by Becca Fitzpatrick (Hush, Hush, Crescendo, Silence, Finale), Nightshade by Andrea R. Cremer (Nightshade, Wolfsbane, Bloodrose, Snakeroot), Wings by Aprilynne Pike (Wings, Spells, Illusions, Destined) and Anna Dressed in Blood by Kendare Blake (Anna Dressed in Blood, Girl of Nightmares). The thesis was divided into eight chapters. In the first chapter we have outlined the historical development of paranormal romance, in the second part we focused on its genre characteristic. In the third and fourth chapters we tried to create a prototype of heroine and hero of this subgenre. The fifth part is about the steady plot schemes in paranormal romances. In the sixth chapter we have tried to determine a model form of relationship main pair of lovers in the analyzed subgenre. In the seventh part we discussed conflict between everyday reality and the supernatural and the social hierarchy in the fiction world of paranormal romances and we introduced supernatural species and races that...

Never before in living memory has the gap in mutual acceptance and understanding between generations been as large as it is now. Massive societal and cultural shifts, fuelled by changing technology, increasing rates of change, globilisation and disconnectedness, have caused a deep divide between those born in the first two-thirds of this century and those born in the latter decades. This dissertation aims to identify the causes of this divide, quantify the effects and suggest solutions. Although generally applicable to many different organisations in society, especially schools, parenting, businesses with young and old employees or those with generationally diverse target markets, this dissertation focuses specifically in application on the context of local churches. It aims to provide an understanding of the concept of a "generation gap" and practical guidelines for churches seeking to become truly multi-generational in their structures and ministries. / Practical Theology / M. Diac. (Youth Work Direction)

Thesis (PhD)--Stellenbosch University, 2015 / AFRIKAANSE OPSOMMING : Hierdie proefskrif is ’n ondersoek na die wyse waarvolgens Duitse jeugboekskrywers die koloniale periode in Afrika uitbeeld. Duitse avontuurliteratuur speel dikwels af in die koloniale periode in Afrika. Motiewe in die avontuurroman stem egter nie altyd ooreen met die historiese konteks en geografiese ruimtes nie. Dit skep die indruk dat so ’n verhaal tyd- en ruimteloos is en dat die historiese en geografiese konteks bloot die afstand tussen Afrika en Europa beklemtoon. In die lig van die feit dat Afrika en sy historiese konteks dikwels as eksotiese agtergrond dien, bespreek die studie die problematiek rondom die manier waarvolgens skrywers die koloniale periode in die avontuurliteratuur ontleed. Vervolgens word die vraag gestel tot watter mate die uitbeelding van Afrika sedert 1945 verander het. Die wyse waarop die koloniale periode in Afrika in Duitse jeugliteratuur uitgebeeld word, behoort dus ondersoek te word binne die konteks van die tradisionele avontuurliteratuur. Deurdat die studie gesentreer is rondom die avontuurliteratuur voor 1945 en avontuurboeke na 1945, stel die dissertasie ondersoek in tot watter mate jeugboeke en hulle uitbeelding van die koloniale periode verander het en in hoeverre die tradisionele avontuurliteratuur aan hierdie boeke ontleen is. In hierdie proefskrif word avontuurverhale en avontuurlike jeugverhale wat tydens die koloniale periode in Afrika afspeel, vervolgens ontleed. Die studie fokus op vier periodes: Eerstens word tradisionele avontuurstories en motiewe wat ’n belangrike rol speel in die uitbeelding van Afrika, geïdentifiseer. Die volgende tekste word ontleed: C.Falkenhorst se Der Baumtöter (1894), Gustav Frenssen se Peter Moors Fahrt nach Südwest (1906), Josef S. Viera se Bana Sikukuu (1924) en Gust in der Klemme (1933), Max Mezger se Aufruhr auf Madagaskar (1930) en Rolf Italiaander se Wüstenfüchse (1934). Tweedens ondersoek die studie die rol wat avontuurmotiewe – inisiasie, weerstand en verowering – speel in jeugboeke wat in die Federale Republiek van Duitsland gepubliseer is. Die volgende tekste word onder die loep geneem: Kurt Lütgen se ...die Katzen von Sansibar zählen (1962), Rolf Italiaander se Mubange, der Junge aus dem Urwald (1957), Herbert Kaufmann se Der Teufel tanzt im Ju-Ju-Busch en sy historiese roman Des Königs Krokodil (1959). Derdens ondersoek die studie watter rol avontuurmotiewe – die edel barbaar (edle Wilde), antiheld en die tweegeveg – speel in jeugboeke wat in die Duitse Demokratiese Republiek gepubliseer is. Die volgende tekste word analiseer: Ferdinand May se roman Sturm über Südwest-Afrika (1962) en Götz R. Richter se Savvytrilogie (1955 – 1963) en Die Löwen kommen (1969). Laastens stel die studie die vraag tot watter mate die kontemporêre avontuurliteratuur – soos Hermann Schultz se sendingroman Auf den Strom (1998) ’n nuwe ontwikkeling toon wat van die tradisionele avontuurliteratuur van die 19de en 20ste eeu afwyk. / ENGLISH ABSTRACT : This dissertation investigates how the African colonial period is portrayed in German youth literature. German adventure literature is often set in the African colonial period. However, motifs in the adventure novel do not always correspond with historical themes and geographical spaces. This gives the impression that such novels stand outside of time and space and that the historical and geographical context merely emphasize the distance between Africa and Europe. In light of the fact that Africa and its historical context are often reduced to an exotic backdrop, questions are raised about the way authors examine the colonial period in the adventure literature and how the portrayal of Africa has changed since 1945. The question how the African colonial period is portrayed in German youth literature is therefore examined within the context of the traditional adventure literature. Reflecting on adventure literature before 1945 on the one hand and adventure stories after 1945 on the other, this study examines to what extent youth books and their portrayal of the colonial period have changed and how these books relate back to the traditional adventure literature. For this purpose, adventure stories and adventurous youth stories and –novels that are set in the colonial period in Africa are analysed and the study focuses on four periods: Firstly, traditional adventure stories and motifs that play an important role in the portrayal of Africa are identified. The following are analysed: C. Falkenhorst’s Der Baumtöter (1894), Gustav Frenssen’s Peter Moors Fahrt nach Südwest (1906), Josef S. Viera’s Bana Sikukuu (1924) and Gust in der Klemme (1933), Max Mezger’s Aufruhr auf Madagaskar (1930) and Rolf Italiaander’s Wüstenfüchse (1934). Secondly, the dissertation investigates what role adventure motifs – initiation, resistance and conquest – play in the youth literature of the Federal Republic of Germany. The following are analysed: Kurt Lütgen’s …die Katzen von Sansibar zählen (1962), Rolf Italiaander’s Mubange, der Junge aus dem Urwald (1957), Herbert Kaufmann’s Der Teufel tanzt im Ju-Ju-Busch and his historical novel Des Königs Krokodil (1959). Thirdly, the study examines adventure motifs – noble savage (edle Wilde), anti-hero and the duel – in the literature published in the German Democratic Republic. These are Ferdinand May’s novel Sturm über Südwest-Afrika (1962) and Götz R. Richter’s Savvy-Trilogie (1955-1963) and Die Löwen kommen (1969). Lastly, the dissertation poses the question to what extent the contemporary adventure literature – like Hermann Schulz’ missionary novel Auf dem Strom (1998) – shows a new development which deviates from the traditional adventure literature of the 19th and 20th century.

In this paper, we investigate how controlled changes to image properties and orientation affect eye movements for repeated viewings of images of natural scenes. We make changes to images by manipulating low-level image content (such as luminance or chromaticity) and/or inverting the image. We measure the effects of these manipulations on human scanpaths (the spatial and chronological path of fixations), additionally comparing these effects to those predicted by a widely used saliency model (L. Itti & C. Koch, 2000). Firstly we find that repeated viewing of a natural image does not significantly modify the previously known repeatability (S. A. Brandt & L. W. Stark, 1997; D. Noton & L. Stark, 1971) of scanpaths. Secondly we find that manipulating image features does not necessarily change the repeatability of scanpaths, but the removal of luminance information has a measurable effect. We also find that image inversion appears to affect scene perception and recognition and may alter fixation selection (although we only find an effect on scanpaths with the additional removal of luminance information). Additionally we confirm that visual saliency as defined by L. Itti and C. Koch's (2000) model is a poor predictor of real observer scanpaths and does not predict the small effects of our image manipulations on scanpaths.

Recent advances in the methods of skeletal age estimation have rekindled interest in their applicability to paleodemography. The current study contributes to the discussion by applying several long established as well as recently developed or refined aging methods to a subsample of 121 adult skeletons from the early medieval cemetery of Lauchheim. The skeletal remains were analyzed by 13 independent observers using a variety of aging techniques (complex method and other multimethod approaches, Transition Analysis, cranial suture closure, auricular surface method, osteon density method, tooth root translucency measurement, and tooth cementum annulation counting). The age ranges and mean age estimations were compared and results indicate that all methods showed smaller age ranges for the younger individuals, but broader age ranges for the older age groups.