Prozessevaluation einer kognitiv-verhaltenstherapeutischen Gruppentherapie bei Diabetes und Depression : Entwicklung und Validierung der Patienten- und Therapeuten- Gruppentherapiestundenbögen (GTS-P, GTS-T, GTS-TP) zur Vorhersage des Therapieerfolgs

Untersucht werden Prozess-Ergebnis-Zusammenhänge einer kognitiv-verhaltenstherapeutischen Gruppentherapie für Diabetes und Depression im Rahmen der DAD-Studie. rnAufgrund des Mangels an geeigneten Erhebungsinstrumenten der validen, ökonomischen und komplementären Sitzungsbewertung von Gruppenpatienten und -therapeuten wurden angelehnt an einen Patienten- (GTS-P) zwei Therapeutenstundenbögen entwickelt: der GTS-T zur Bewertung der Gesamtgruppe und der GTS-TP zur Bewertung einzelner Patienten. Die GTS-Bögen zeigen bei der Überprüfung der Testgüte insgesamt gute Itemparameter und Reliabilitäten. Das in den exploratorischen Faktorenanaylsen des GTS-P identifizierte zweifaktorielle Modell (1. wahrgenommene Zuversicht hinsichtlich der Gruppentherapie, 2. wahrgenommene persönliche Beteiligung) kann in den konfirmatorischen Faktorenanalysen bestätigt werden. Dazu wurden GTS-P-Daten aus einer Untersuchung mit Patienten mit somatoformen Störungen (Schulte, 2001) einbezogen. Den Ergebnissen der Item- und Faktorenanalysen folgend, wurden zwei Items des GTS-P und zwei weitere Items des GTS-T aus den Instrumenten ausgeschlossen. Für den GTS-T zeigt sich eine einfaktorielle, für den GTS-TP eine zum GTS-P parallele zweifaktorielle Struktur. rnIn den Mehrebenenanalysen zur Vorhersage des Therapieergebnisses (Post-Depressionssymptomatik) zeigt sich die Skala Zuversicht des GTS-P zu Therapiebeginn (1.-4. Sitzung) kontrolliert an der Skala Beteiligung und der Prä-Symptomatik, als valider Prädiktor. Das Item 5 „Anregungen“ (Skala Zuversicht) und Item 2 „Aktive Mitwirkung“ (Skala Beteiligung) sind am stärksten an diesem Effekt beteiligt, da diese Itemkombination das Therapieergebnis ebenfalls valide vorhersagen kann. Die Prognose ist schon durch die Werte der ersten Gruppentherapiesitzungen in der Remoralisierungsphase (Howard et al., 1993) möglich und verbessert sich nicht bei Berücksichtigung aller 10 Gruppensitzungen. Die Therapeutenbögen zeigen keine prädiktive Validität. Bedeutsame Zusammenhänge der Patienten- und Therapeutenbewertungen finden sich lediglich für den GTS-P und GTS-TP. Weitere Prädiktoren, wie der Diabetestyp, Diabeteskomplikationen und die Adhärenz, konnten nicht zur Verbesserung der Vorhersage beitragen. Für sekundär überprüfte Kriterien gelang die Prognose lediglich für ein weiteres Maß der Depressionssymptomatik und für eine Gesamtbewertung der Gruppentherapie durch die Patienten zu Therapieende. Bei der deskriptiven Betrachtung der Prozessqualität der DAD-Gruppentherapien zeigen sich positive, über den Verlauf der Gruppe zunehmende und nach Therapiephasen differenzierbare Bewertungsverläufe. rnDie Ergebnisse der Studie sprechen für die Relevanz von unspezifischen Wirkfaktoren für das Therapieergebnis von kognitiv-behavioralen Gruppentherapien. Die von den Gruppenpatienten wahrgenommene Zuversicht und Beteiligung als Zeichen der Ansprechbarkeit auf die Therapie sollte mit Hilfe von Stundenbögen, wie den GTS-Bögen, von Gruppentherapeuten zur Prozessoptimierung und Prävention von Therapieabbrüchen und Misserfolgen beachtet werden. rn

Influence of pollination and seed dispersal on the genetic population structure of two Commiphora species in Madagascar and South Africa

Pollination and seed dispersal are important ecological processes for the regeneration of plant populations and both vectors for gene exchange between plant populations. For my thesis, I studied the pollination ecology of the South African tree Commiphora harveyi (Burseraceae) and compared it with C. guillauminii from Madagascar. Both species have low visitation rates and a low number of pollinating insect species, resulting in a low fruit set. While their pollination ecology is very similar, they differ in their seed dispersal with a low seed dispersal rate in the Malagasy and a high seed dispersal rate in the South African species. This should be reflected in a stronger genetic differentiation among populations in the Malagasy than in the South African species. My results, based on AFLP markers, contradict these expectations, the overall differentiation was lower in the Malagasy (FST = 0.05) than in the South African species (FST = 0.16). However, at a smaller spatial scale (below 3 km), the Malagasy species was genetically more strongly differentiated than the South African species, which was reflected by the high inter-population variance within the sample site (C. guillauminii: 72.2 - 85.5 %; C. harveyi: 8.4 - 14.5 %). This strong differentiation could arise from limited gene flow, which was confirmed by spatial autocorrelation analyses. The shape of the autocorrelogram suggested that gene exchange between individuals occurred only up to 3 km in the Malagasy species, whereas up to 30 km in the South African species. These results on the genetic structure correspond to the expectations based on seed dispersal data. Thus, seed dispersal seems to be a key factor for the genetic structure in plant populations on a local scale.

Measurement of the elastic electron-proton cross section and separation of the electric and magnetic form factor in the Q 2 range from 0.004 to 1 (GeV/c) 2

The electromagnetic form factors of the proton are fundamental quantities sensitive to the distribution of charge and magnetization inside the proton. Precise knowledge of the form factors, in particular of the charge and magnetization radii provide strong tests for theory in the non-perturbative regime of QCD. However, the existing data at Q^2 below 1 (GeV/c)^2 are not precise enough for a hard test of theoretical predictions.rnrnFor a more precise determination of the form factors, within this work more than 1400 cross sections of the reaction H(e,e′)p were measured at the Mainz Microtron MAMI using the 3-spectrometer-facility of the A1-collaboration. The data were taken in three periods in the years 2006 and 2007 using beam energies of 180, 315, 450, 585, 720 and 855 MeV. They cover the Q^2 region from 0.004 to 1 (GeV/c)^2 with counting rate uncertainties below 0.2% for most of the data points. The relative luminosity of the measurements was determined using one of the spectrometers as a luminosity monitor. The overlapping acceptances of the measurements maximize the internal redundancy of the data and allow, together with several additions to the standard experimental setup, for tight control of systematic uncertainties.rnTo account for the radiative processes, an event generator was developed and implemented in the simulation package of the analysis software which works without peaking approximation by explicitly calculating the Bethe-Heitler and Born Feynman diagrams for each event.rnTo separate the form factors and to determine the radii, the data were analyzed by fitting a wide selection of form factor models directly to the measured cross sections. These fits also determined the absolute normalization of the different data subsets. The validity of this method was tested with extensive simulations. The results were compared to an extraction via the standard Rosenbluth technique.rnrnThe dip structure in G_E that was seen in the analysis of the previous world data shows up in a modified form. When compared to the standard-dipole form factor as a smooth curve, the extracted G_E exhibits a strong change of the slope around 0.1 (GeV/c)^2, and in the magnetic form factor a dip around 0.2 (GeV/c)^2 is found. This may be taken as indications for a pion cloud. For higher Q^2, the fits yield larger values for G_M than previous measurements, in agreement with form factor ratios from recent precise polarized measurements in the Q2 region up to 0.6 (GeV/c)^2.rnrnThe charge and magnetic rms radii are determined as rn⟨r_e⟩=0.879 ± 0.005(stat.) ± 0.004(syst.) ± 0.002(model) ± 0.004(group) fm,rn⟨r_m⟩=0.777 ± 0.013(stat.) ± 0.009(syst.) ± 0.005(model) ± 0.002(group) fm.rnThis charge radius is significantly larger than theoretical predictions and than the radius of the standard dipole. However, it is in agreement with earlier results measured at the Mainz linear accelerator and with determinations from Hydrogen Lamb shift measurements. The extracted magnetic radius is smaller than previous determinations and than the standard-dipole value.

Feasibility studies for accessing nucleon structure observables with the PANDA experiment at the future FAIR facility

The availability of a high-intensity antiproton beam with momentum up to 15,GeV/c at the future FAIR will open a unique opportunity to investigate wide areas of nuclear physics with the $overline{P}$ANDA (anti{$overline{P}$}roton ANnihilations at DArmstadt) detector. Part of these investigations concern the Electromagnetic Form Factors of the proton in the time-like region and the study of the Transition Distribution Amplitudes, for which feasibility studies have been performed in this Thesis. rnMoreover, simulations to study the efficiency and the energy resolution of the backward endcap of the electromagnetic calorimeter of $overline{P}$ANDA are presented. This detector is crucial especially for the reconstruction of processes like $bar pprightarrow e^+ e^- pi^0$, investigated in this work. Different arrangements of dead material were studied. The results show that both, the efficiency and the energy resolution of the backward endcap of the electromagnetic calorimeter fullfill the requirements for the detection of backward particles, and that this detector is necessary for the reconstruction of the channels of interest. rnrnThe study of the annihilation channel $bar pprightarrow e^+ e^-$ will improve the knowledge of the Electromagnetic Form Factors in the time-like region, and will help to understand their connection with the Electromagnetic Form Factors in the space-like region. In this Thesis the feasibility of a measurement of the $bar pprightarrow e^+ e^-$ cross section with $overline{P}$ANDA is studied using Monte-Carlo simulations. The major background channel $bar pprightarrow pi^+ pi^-$ is taken into account. The results show a $10^9$ background suppression factor, which assure a sufficiently clean signal with less than 0.1% background contamination. The signal can be measured with an efficiency greater than 30% up to $s=14$,(GeV/c)$^2$. The Electromagnetic Form Factors are extracted from the reconstructed signal and corrected angular distribution. Above this $s$ limit, the low cross section will not allow the direct extraction of the Electromagnetic Form Factors. However, the total cross section can still be measured and an extraction of the Electromagnetic Form Factors is possible considering certain assumptions on the ratio between the electric and magnetic contributions.rnrnThe Transition Distribution Amplitudes are new non-perturbative objects describing the transition between a baryon and a meson. They are accessible in hard exclusive processes like $bar pprightarrow e^+ e^- pi^0$. The study of this process with $overline{P}$ANDA will test the Transition Distribution Amplitudes approach. This work includes a feasibility study for measuring this channel with $overline{P}$ANDA. The main background reaction is here $bar pprightarrow pi^+ pi^- pi^0$. A background suppression factor of $10^8$ has been achieved while keeping a signal efficiency above 20%.rnrnrnPart of this work has been published in the European Physics Journal A 44, 373-384 (2010).rn

Nucleon electromagnetic structure studies in the spacelike and timelike regions

The thesis investigates the nucleon structure probed by the electromagnetic interaction. One of the most basic observables, reflecting the electromagnetic structure of the nucleon, are the form factors, which have been studied by means of elastic electron-proton scattering with ever increasing precision for several decades. In the timelike region, corresponding with the proton-antiproton annihilation into a electron-positron pair, the present experimental information is much less accurate. However, in the near future high-precision form factor measurements are planned. About 50 years after the first pioneering measurements of the electromagnetic form factors, polarization experiments stirred up the field since the results were found to be in striking contradiction to the findings of previous form factor investigations from unpolarized measurements. Triggered by the conflicting results, a whole new field studying the influence of two-photon exchange corrections to elastic electron-proton scattering emerged, which appeared as the most likely explanation of the discrepancy. The main part of this thesis deals with theoretical studies of two-photon exchange, which is investigated particularly with regard to form factor measurements in the spacelike as well as in the timelike region. An extraction of the two-photon amplitudes in the spacelike region through a combined analysis using the results of unpolarized cross section measurements and polarization experiments is presented. Furthermore, predictions of the two-photon exchange effects on the e+p/e-p cross section ratio are given for several new experiments, which are currently ongoing. The two-photon exchange corrections are also investigated in the timelike region in the process pbar{p} -> e+ e- by means of two factorization approaches. These corrections are found to be smaller than those obtained for the spacelike scattering process. The influence of the two-photon exchange corrections on cross section measurements as well as asymmetries, which allow a direct access of the two-photon exchange contribution, is discussed. Furthermore, one of the factorization approaches is applied for investigating the two-boson exchange effects in parity-violating electron-proton scattering. In the last part of the underlying work, the process pbar{p} -> pi0 e+e- is analyzed with the aim of determining the form factors in the so-called unphysical, timelike region below the two-nucleon production threshold. For this purpose, a phenomenological model is used, which provides a good description of the available data of the real photoproduction process pbar{p} -> pi0 gamma.