Neural correlates of reward frustration are increasingly studied in humans. In line with prediction error theory, omission of an expected reward is associated with relative decreases of cerebral activation in dopaminergic brain areas. We investigated whether a history of chronic work-related reward frustration influences this reward-dependent activation pattern by means of functional magnetic resonance imaging. Solving arithmetic tasks was followed by either monetary reward or omission of reward. Hyperactivations in the medial prefrontal, anterior cingulate and dorsolateral prefrontal cortex were observed in a group of healthy adults with high susceptibility to reward frustration as compared with a group with low susceptibility. Findings indicate a compromised ability of adapting brain activation among those suffering form chronic social reward frustration.

Objective: To explore the outcomes of monthly video consultations for children with diabetes. Methods: The Virtual Outpatient Diabetes Clinic for Children and Youth (VIDIKI) was a 6-month multicenter controlled clinical trial followed by an extension phase. The 240 participants (1-16 years), all using a CGM, were quasi-randomized by residence location to the intervention group (IG) or the waitlist-control group (WG). The IG started immediately after enrollment with monthly video consultations as an add-on to regular care, while the WG received regular care for 6 months before starting the intervention. The extension phase lasted between 12 months and 2 years, depending on the enrollment date. Linear regression was applied to model the primary outcome of HbA1c after 6 months and other metabolic and psychosocial outcomes. Results: After covariate adjustments, the HbA1c at 6 months-corresponding to the controlled treatment phase-was 0.11% lower in the IG than that in the WG (95% CI −0.31 to 0.09, P = .277). For the total study sample, a significant HbA1c improvement was found after 12 months of video consultations, which increased further until month 15. The diabetes burden of the main caregivers was lower, and parental treatment satisfaction was significantly higher in the IG than that in the WG. Conclusions: The VIDIKI study found no significant HbA1c difference between IG and WG after 6 months in the controlled phase, but there was a decreased diabetes burden and increased treatment satisfaction for the parents. In the longitudinal perspective, a significant HbA1c improvement was found after 12 and 15 months.

Aim Previous studies have demonstrated a positive effect of school-based life skills programmes on the prevention of substance abuse and other health-risk behaviours in children and adolescents. However, the comparison and interpretation of study results is difficult due to methodological problems. In particular, the effectiveness of such programmes within high-risk groups remains uncertain. In this study, we investigated the effects of two school-based life skills programmes on substance abuse and subjective health in a sample with a high proportion of socially disadvantaged pupils. Subjects and methods We conducted a randomised controlled intervention study with repeated measurements over time. The sample included pupils of secondary schools in northern Germany with an overrepresentation of pupils with low socioeconomic status. We evaluated effects of the programmes on substance abuse and psychosocial outcomes. In addition, we conducted a process evaluation. ResultsThe sample included 102 classes with a total of 1,561 pupils. Twenty-five per cent of the pupils were of a low socioeconomic status. We found significant positive effects regarding the reduction of smoking and some improvements in the pupils' life skills in the intervention group compared to the control group. Socioeconomic status had no moderating effect on the results. Conclusion School-based life skills programmes have a positive effect on smoking prevention regardless of socioeconomic status. Socially disadvantaged children benefit from such programmes to a similar extent as other pupils. Pupils and teachers appreciate the programmes. A supportive school environment appears to be an important factor in the successful implementation of school-based life skills programmes.

Background: The introduction of continuous glucose monitoring (CGM) implies new challenges for diabetes care. As CGM systems are often directly linked to a web-based software solution, structured telemedicine care using a video-consultation may be a new option for families who care for children with type 1 diabetes mellitus (T1DM). Methods: “ViDiKi” (Virtual Diabetes Outpatient Clinic for Children and Youth) is a multicenter controlled trial carried out in Northern Germany. ViDiKi will examine if monthly telemedical consultations, in addition to regular care, will improve glycemic control and psychosocial outcomes. The primary outcome is glycemic control as measured by a change in glycated hemoglobin (HbA1c). A total of 240 participants aged between one year and 16 years using a CGM with multiple daily injections (MDI) or insulin pump therapy were recruited and assigned to a starter group or a six-month waiting control group. The sample size is designed to detect a between-group difference of 0.5% in HbA1c change at six months. Secondary outcomes are variability of blood glucose, health-related quality of life, self-efficacy, and satisfaction with telemedicine. To gain deeper insight into the experience of using telemedicine, qualitative interviews will be conducted. In a health-economic analysis, the costs of telemedicine and a cost-of-care analysis will be calculated. Conclusions: The results from the ViDiKi study shall give important information on the feasibility and putative benefits of telemedicine in children with T1DM and their caregivers. German Clinical Trails Register (DRKS): DRKS00012645

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