Effectiveness of the Cognitive Behavior Therapy in the Treatment of Generalized Anxiety Disorders – Results of the Berlin GAD-KVT-Study Background: In recent years generalized anxiety disorders (GAD) have become a focus of clinical research. There is some empirical evidence that cognitive behavior therapy (CBT) is an effective treatment. But the available studies have some shortcomings which do not allow generalizations to treatment under routine conditions. Method: In a multicenter controlled clinical trial supported by the Deutsche Forschungsgemeinschaft, efficacy of manual-guided CBT was studied in cooperation with behavior therapists who work in private practice. The design and methodology of the study adhere to the same rules as are valid in pharmacotherapy trials. Patients treated with CBT (TA) were compared with those of a waiting contact group (KKG). Because the control group patients were also treated with CBT after the waiting period (TB), a validation of treatment results has been possible. 72 outpatients (age 18–65 years, HAM-A ≧ 18, GAD according to DSM-IV, no co-morbid axis-I or axis-II disorders, no co-medication) were included and randomized into the study arms. Results: In TA HAM-A showed a reduction pre-post of 10.64 (39.6%) and STAI state of 7.96 (15.1%). In TB (those patients with delayed start of therapy) the reduction in the HAM-A was 12.08 (56.9%) and in the STAI state 6.62 (13.5%). In KKG the reduction was 1.22 (5.3%) in the HAM-A and 1.63 (3.2%) in the STAI state. Differences between TA or TB and KKG were statistically highly significant. Conclusion: The data show that manual-guided CBT is effective in GAD. Results are statistically significant and clinically meaningful. The study also shows that multicenter trials are also feasible in psychotherapy research.
As the complexity of automated assembly systems increases, so does the number of errors which arise during their development. The challenge is to avoid these errors already in an early stage, thus reducing development time and costs. This cannot be done without using digital simulation methods. In order to be able to apply these methods in an effective way, the digital simulation models need to abstract reality as much as possible. One key topic is the simulation of the physical behaviour of the components in assembly system. In order to be able to simulate this behavior, additional information within the simulation model is required. This paper proposes a methodology to build such models. The method focuses on identifying what kind of information is necessary for each type of component in order to achieve the desired realism. In doing so an automated and therefore less laborious modeling is possible.
It has been shown, that apart from the mass of non-vital squamous epithelial cells, there also exist vital cells in the amniotic fluid. In this study, two types of amniotic fluid cells, which upon examination based on morphological characteristics gave rise to conclusions concerning their vitality, are presented, described and correlated with morphologically similar cells with known origin. Probably one type of these amniotic fluid cells are macrophages or Hofbauer-cells and the other types could be amnion-cells.
