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Abstract Background Several recent publications have demonstrated the use of convolutional neural networks to classify images of melanoma at par with board-certified dermatologists. However, the non-availability of a public human benchmark restricts the comparability of the performance of these algorithms and thereby the technical progress in this field. Methods An electronic questionnaire was sent to dermatologists at 12 German university hospitals. Each questionnaire comprised 100 dermoscopic and 100 clinical images (80 nevi images and 20 biopsy-verified melanoma images, each), all open-source. The questionnaire recorded factors such as the years of experience in dermatology, performed skin checks, age, sex and the rank within the university hospital or the status as resident physician. For each image, the dermatologists were asked to provide a management decision (treat/biopsy lesion or reassure the patient). Main outcome measures were sensitivity, specificity and the receiver operating characteristics (ROC). Results Total 157 dermatologists assessed all 100 dermoscopic images with an overall sensitivity of 74.1%, specificity of 60.0% and an ROC of 0.67 (range = 0.538–0.769); 145 dermatologists assessed all 100 clinical images with an overall sensitivity of 89.4%, specificity of 64.4% and an ROC of 0.769 (range = 0.613–0.9). Results between test-sets were significantly different (P < 0.05) confirming the need for a standardised benchmark. Conclusions We present the first public melanoma classification benchmark for both non-dermoscopic and dermoscopic images for comparing artificial intelligence algorithms with diagnostic performance of 145 or 157 dermatologists. Melanoma Classification Benchmark should be considered as a reference standard for white-skinned Western populations in the field of binary algorithmic melanoma classification. Highlights • This paper provides the first open access melanoma classification benchmark for both non-dermoscopic and dermoscopic images. • Algorithms can now be easily compared to the performance of dermatologists in terms of sensitivity, specificity and ROC. • The melanoma benchmark allows comparability between algorithms of different publications and provides a new reference standard. [ABSTRACT FROM AUTHOR]

• Perceptions differed between frontline workers in child welfare and child and adolescent psychiatric (CAP) clinics. • Child welfare professionals perceived the general interprofessional collaboration significantly less positively. • CAP clinics perceived the collaboration on cases involving children with complex care needs significantly less positively. • Attention should be given to organizational support in child welfare for building collaborative relationships with CAP. In Germany (and other countries) a significant proportion of children and young people in contact with the child welfare system do not receive adequate mental health care. Fragmented service delivery has been partially attributed to a lack of interprofessional collaboration between the child welfare system and providers of child mental health services. Child and adolescent psychiatric (CAP) clinics provide the majority of child mental health care for the child welfare population in Germany. In this paper, we present the first wave of data collected in a nonrandomized pretest–posttest intervention study, in which we examined the collaboration between child welfare services and CAP clinics in Northern Germany with a sample of N = 204 professionals in total, from both organizations. We used two standardized measurements. The general quality of collaboration was measured using an established tool, the "Perceptions of Interprofessional Collaboration Model – Questionnaire" (PINCOM-Q). Perceptions of collaboration around children with complex care needs were measured with a newly developed scale, the "Perceptions of Interprofessional Collaboration Scale for Children with Multiple and Complex Needs" (PICOCC). The results show that perceptions of interprofessional collaboration differed based on organizational and professional affiliation. Frontline workers employed in the child welfare system compared to those working in CAP clinics had a more negative perception of collaboration in general, and felt their organization provided less support for collaboration. Social workers in both CAP and child welfare services perceived less organizational support for collaboration compared to mental health professionals. In the overall group of social workers, those working in the child welfare system felt their organization supported collaboration the least. Mental health professionals working in CAP clinics, however, had a more negative perception of collaboration around children with complex needs. This suggests that attention should be paid to perceptions of interprofessional collaboration as an important process variable, which may impact on frontline workers' responsiveness to organizational change. [ABSTRACT FROM AUTHOR]

Objectives The objective of this survey was to analyse vaccination rates and attitudes towards vaccination among health care workers (HCWs). The period prevalence of self-reported acute respiratory infections in the influenza season 2014/2015 was examined. Study design A cross-sectional study was conducted among HCWs of a German university hospital using an anonymised questionnaire. Recruitment was performed by providing all medical and nursing staff a paper questionnaire with an invitation to participate. Methods Descriptive aggregated data were generated from digitalised questionnaires for all variables. Differences in categorical variables were analysed by Chi-squared test. Textual data were analysed by an iterative process based on the grounded theory by Glaser and Strauss. Results The response rate was 31% (677/2186). Probable influenza was described by 9% (64/677) of the participants. The overall self-reported vaccination rate was 55% (366/666). Self-reported vaccination rate was higher in physicians (172/239, 72%) than in nursing staff (188/418, 45%). HCWs in paediatrics (103/148, 70%) more likely received vaccines than HCWs in surgery (31/84, 37%). Most vaccinations were provided by medical staff on the wards (164/368, 45%). Self-reported lost work-time due to adverse events after vaccination was low (6/336, 2%). Eight categories for vaccine refusal were identified, whereof doubts about effectiveness and indication of the vaccine was most frequently mentioned (72/202, 36%). Conclusions Efforts to promote vaccination should focus on nursing staff and should provide scientific evidence on effectiveness, adverse effects, and the benefits of health care workers' vaccination for patients. Administering vaccines at the workplace proved to be a successful strategy in our setting. Studies are needed to assess the frequency of influenza causing disease in HCWs. [ABSTRACT FROM AUTHOR]

Background: In recent years, marketplaces in the darknet emerged where vendors and customers can exchange illicit drugs and other goods on digital platforms by using hidden internet services. The main thesis of this paper is that in an online environment, different practices for building trust and reputation emerge that stabilise market processes.Methods: Qualitative and quantitative data from a recent German project on conventional (offline) small-scale drug dealing as well as qualitative case studies on four online vendors operating on Agora market are used to explore alternative practices for building trust and reputation. They also explore the use of violence and logistics established on cryptomarkets in comparison to traditional dealing. To analyse the data we applied qualitative content analyses.Results: For conventional commercial illicit drug dealing on various kinds of markets, trust between buyer and seller is a crucial issue, often emphasized by restricting deals to well-known persons. While this typically includes face-to-face contact, the opposite is true with online drug trading. It is characteristic of cryptomarkets that the parties involved in a transaction know neither the personal identity nor the physical location of one another. This is realised by using aliases, anonymising software, and cryptocurrencies for payments. Violence typically only plays a role in traditional drug dealing, but mostly, if at all, just as a latent threat for potential rule-breakers. Processing a transaction anonymously includes escrow services for the buyers, which makes trading more reliable, although they cannot completely prevent scamming. Furthermore, online drug marketplaces usually offer a customer feedback system that allows customers to rate vendors and review products. A positive vendor feedback helps building reputation and trust in such an online environment. With regard to logistics, most conventional small-scale dealers restrict their acts of selling to private surroundings to avoid encounters with law enforcement. In cryptomarkets, the purchased drugs are delivered by traditional postal services, sometimes to false addresses or to someone else's name to conceal the identity and address of the buyer.Conclusion: On virtual drug markets practices of building trust, conflict resolution and logistics is constantly evolving. They offer improved security solutions on the one hand while on the other hand scamming and fraud seem to be widely used on both online and conventional drug markets. [ABSTRACT FROM AUTHOR]

Background: Cannabis prohibition can generally be regarded as the main driver for home growing of marijuana. In this paper, I discuss the impact of drug prohibition on cannabis cultivators from the three German-speaking countries: Germany, Austria and Switzerland. In particular, this refers to the questions; how illicitness influences motivations for growing; which precautionary measures are taken against the risk of discovery; how penal consequences differ in the three countries and how these aspects are linked to each other.Methods: The results come from a sample of 1578 respondents from the German-language online survey conducted following the International Cannabis Cultivation Questionnaire (ICCQ). The survey was carried out in late 2012 and early 2013.Results: While most of the reasons for growing cannabis relate to avoiding negative consequences of prohibition, the illicitness of cannabis also plays a major role for concern about the cultivation activities as well as measures to avoid negative consequences. Swiss growers are less worried about their activity compared to respondents from Germany or Austria.Conclusion: The results confirm the notion that the illicitness of cannabis is the main drive for the private cultivation of the plant. At the same time, prohibition is the principal reason for concern regarding the growing activity. The severity of possible sentences seems to be linked to the degree of concern and precautionary measures. [ABSTRACT FROM AUTHOR]

The present paper aims at exploring the new phenomenon of social network site (SNS) addiction and at identifying predictors of problematic SNS use. For this purpose, a scale measuring addictive behavior specifically with regard to SNS use was developed. The effects of intrinsic need satisfaction in the offline context and of SNS-specific motives on SNS addiction were tested in an online-survey among 581 SNS users in Germany. It was hypothesized that motives mediate the influence of thwarted intrinsic need satisfaction on addictive behavior on SNSs. More precisely, we assumed that a lack of autonomy leads to a higher motivation to use SNSs for self-presentation and escapism, a lack of competence predicts the motive to use SNSs for acquiring information and self-presentation, and a lack of relatedness fosters users’ motives to use SNSs for self-presentation and meeting new people. These motives, in turn, were predicted to be associated with higher levels of SNS addiction. All proposed mediation models were supported by the data. The results emphasize the importance of incorporating both offline need satisfaction and gratifications sought through the use of SNS to provide a comprehensive perspective on addictive behavior on SNSs. [ABSTRACT FROM AUTHOR]

• Instrument to assess family–school partnerships showed to be reliable and valid. • Welcoming culture and effective communication were reported to be relatively high. • Cooperation and parent participation were reported to be relatively low. • Only effective communication was related with more parent–child communication. Based on the Parent–Teacher Association's Standards for Family–School Partnerships (FSP), German experts on education proposed four standards for quality features of FSP in Germany: (A) welcoming and meeting culture, (B) various and respectful communication, (C) educational cooperation, and (D) parent participation. The aims of this paper were to develop a measurement instrument for the assessment of these quality features of FSP from parents' perspective, and to examine their associations with parent–child communication about school as an important aspect of parental involvement. N = 309 parents—whose children attend different school types—participated in an online survey. The analyses demonstrated that parents reported relatively high levels of standards A and B, but relatively low levels of standards C and D. Controlling for child and family characteristics, standard B (but no other standard) was found to be positively associated with parent–child communication. [ABSTRACT FROM AUTHOR]

• Techniques for late spontaneous recovery from stuttering clustered into six strategies. • The strategies reflect components of established treatments and naïve explanations. • Causal attributions of recovery clustered into three implicit theories about recovery. • Knowledge about strategies and implicit theories may help to improve treatment. (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components. 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions. A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained). Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions. The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies. [ABSTRACT FROM AUTHOR]