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Background: Reading comprehension is frequently impaired in persons with aphasia (PWA). For goal‐setting and outcome measurement, speech and language therapists (SLTs) need to determine an individual's perspective of their reading difficulties and everyday reading activities. The Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire provides a person‐centred tool to find out the individual perception of reading functions, reading‐related emotions and reading activities in PWA. It was developed and evaluated in English. So far, there is no equivalent instrument in German. Aims: To translate and adapt the CARA reading questionnaire into German language and culture, to evaluate its practicability and acceptance, and to provide the first psychometric properties of the German version. Methods & Procedures: Based on translation and adaptation guidelines, we conducted two forward translations that were merged and then adapted. A back translation was prepared and compared with the original version. It was found to be semantically equivalent by one of the authors of the original version. We performed pilot testing with 12 PWA, and the pilot version was adapted according to the comments of these participants. We then collected data on self‐reported perception of reading and on psychometric properties of the translated and adapted German version. A total of 22 German‐speaking PWA completed the questionnaire at least five times during an intervention study. We analysed retest reliability with Spearman correlation, internal consistency with Cronbach's alpha, internal responsiveness with the standardized response mean, as well as the relationship between outcomes of the questionnaire and text comprehension measures using repeated measures correlations. Outcomes & Results: Our data suggest good practicability and acceptance of the German version of the CARA reading questionnaire as well as appropriate validity, reliability and sensitivity to measure therapy‐induced change. We found moderate correlations between outcomes of the questionnaire and text‐level reading speed. Conclusions & Implications: The German version of the CARA reading questionnaire could be helpful in intervention planning and goal‐setting with German‐speaking PWA. By using the questionnaire, SLTs can find out about a person's individual perception of reading difficulties as well as individually relevant reading activities. The questionnaire provides a tool to measure change and is therefore valuable to demonstrate self‐reported individual progress. As reading speed seems to be an indicator of personal perception of reading difficulty, it is important to consider reading speed in reading interventions and in reading comprehension assessments. WHAT THIS PAPER ADDS: What is already known on the subject: Reading comprehension is frequently impaired in PWA. Reading preferences, the perception of difficulties and the impact on everyday life reading activities are specific to the individual and thus need to be known for goal‐setting, intervention planning and monitoring of change. As part of a comprehensive assessment of reading, Morris et al. developed a person‐centred English language questionnaire for this purpose. So far, there is no equivalent tool in German. What this paper adds to the existing knowledge: In this study, we translated and adapted the questionnaire to German language and culture, and analysed its validity and reliability with German‐speaking PWA. We demonstrated that the German version is accessible for German‐speaking PWA, and that it has appropriate validity, reliability and sensitivity to measure self‐reported change. Outcomes of the questionnaire correlate with text level reading speed. What are the potential or actual clinical implications of this work?: The German version of the questionnaire could be a valuable self‐reported outcome measure to assess individual perceptions of reading and to measure progress (as perceived by an individual) as a consequence of recovery or intervention in either clinical or research settings. As reading speed might be an indicator of everyday life reading as perceived by an individual, it should be considered in reading assessments and interventions. [ABSTRACT FROM AUTHOR]

This paper explores the knowledge transfer of internationally mobile scientists. It builds upon previous work on the development of methods for detecting the knowledge transfer of German scientists. Using abstract terms of publications covered in Scopus, this paper proposes a lexical‐based approach to identify knowledge transmitters. These scientists are characterized by acquiring knowledge from their co‐workers during their international stay and transferring it upon return to German co‐workers. Knowledge is operationalized as the co‐occurrence of rarely used abstract terms. Knowledge transfer is expressed as the diffusion of these term combinations in co‐authorship networks. The method developed was validated by contacting the bibliometrically identified knowledge transmitters and asking them what they believe they learned during their stay abroad. A control group of internationally mobile scientists without traceable knowledge transfer was similarly asked to report on their knowledge acquisition. The findings suggest that bibliometric data are capable of detecting knowledge transmitters among German scientists who were internationally mobile. The juxtaposition of the responses on their perceived knowledge acquisition and the bibliometrically identified lexical terms shows that the method proposed is well suited to studying the knowledge transfer of internationally mobile scientists. The strength of the method is its simplicity and high precision. [ABSTRACT FROM AUTHOR]

Aim: To describe activities and professional characteristics of nurses in expanded roles in acute care in Germany and achieve a greater understanding of the current situation of advanced practice nursing. Background: Advanced practice nursing plays an important role in meeting increased demands in healthcare and promoting high‐quality care. Introduction: In Germany, advanced practice nursing is still at an early stage with a lack of studies describing the scope of practice of nurses in expanded roles. Methods: We conducted a cross‐sectional‐study using a paper‐and‐pencil questionnaire. In a nationwide convenience sample, we surveyed nurses with an academic degree, who work in an acute care hospital and take over expanded roles in direct patient care. Reporting followed the STROBE checklist. Results: Of 108 eligible nurses, 84 (77%) completed the survey. The majority had a Master's degree (63.1%) and the average work experience was 18.2 years. Participants carried out activities in all the domains that were queried (direct clinical practice, guidance and coaching, consultation, leadership and research) with differences within and between domains. Foci were on direct clinical practice and coaching and guidance. Discussion: In Germany, qualifications are nearing the international standard of advanced practice nursing. Results suggest that participants partly undertake activities within the scope of registered nurses' practice that do not correspond fully to their formal qualifications. Conclusion and implications for nursing and/or health policy: In order to foster the role development of expanded practice nurses in Germany, political efforts are needed in terms of training (e.g. specific Master's programmes), funding of corresponding positions in practice and control mechanisms (e.g. professional registration). [ABSTRACT FROM AUTHOR]

Background: People with aphasia (PWA) frequently experience difficulties in understanding longer written content such as paragraphs or books. Reading strategies are a promising approach to treat text‐level reading comprehension deficits in PWA. Nevertheless, empirical evidence for their efficacy remains rare. Aims: The primary objective of this study was to analyse the efficacy of a strategy‐based intervention on text‐level reading comprehension in PWA. Secondary objectives were to compare the effects of two strategy‐based intervention components and to explore potential moderator effects. Methods & Procedures: A protocol was published prior to data acquisition. In a repeated measures trial, 26 German participants with chronic, post‐stroke aphasia participated in a waiting period without aphasia treatment (control condition) followed by a strategy‐based intervention called 'Strategiebasierte Textverständnis‐Therapie bei Aphasie' (StraTexT, 14 face‐to‐face‐sessions, twice per week, 60 min each). Two strategy combinations, Intervention Micro targeting microstructure and Intervention Macro targeting macrostructure, were applied to newspaper and magazine articles. Participants were randomly allocated to two parallel groups that received these strategy combinations in interchanged sequences. Assessments were implemented before and after each period as well as 3 and 6 months after the intervention. The primary outcome measure was text‐level reading comprehension measured with the total score of a German version of the Test de Compréhension de Textes (TCT‐D). Secondary outcome measures addressed the self‐reported perception of reading abilities, reading activities and feelings about reading (German version of the Comprehensive Assessment of Reading in Aphasia CARA reading questionnaire) as well as selected cognitive functions. Outcomes & Results: The per‐protocol‐analysis included data from 22 participants. We found significant small improvements up to 6 months post‐intervention compared to pre‐intervention in the TCT‐D Total (d = 0.35–0.46) as well as medium to large improvements in the CARA questionnaire (d = 0.68–0.96). Up to 3 months after the intervention, treatment‐induced improvements in the TCT‐D Total were significantly larger than change without treatment during the control condition. There was no evidence of moderator effects. Furthermore, we found improvements in several cognitive functions. Conclusions & Implications: Reading strategies can lead to long‐term improvements in text‐level reading comprehension and in self‐reported reading abilities, feelings about reading and reading activities in aphasia. In regular clinical settings, it seems reasonable to implement both Intervention Micro and Intervention Macro. It remains important to investigate participant characteristics that contribute to treatment success. WHAT THIS PAPER ADDS: What is already known on the subject: Systematic reviews and multiple case studies suggest that reading strategies are a promising approach to treat text‐level reading comprehension in aphasia. The efficacy of reading strategies has been demonstrated for different populations. However, to date no group study has evaluated the efficacy of reading strategies on text‐level reading comprehension in people with aphasia. What this study adds: This study provides the first group‐level evidence about the efficacy of a systematic strategy‐based intervention in 22 people with post‐stroke chronic aphasia. During 14 treatment sessions, participants applied four reading strategies to newspaper and magazine articles within two intervention components called Intervention Micro and Intervention Macro (two strategies per intervention component). We found improvements in text‐level reading comprehension for at least 3 months post‐intervention, as well as effects on selected cognitive functions and self‐reported reading abilities, thoughts and feelings about reading and the ability to engage in reading activities. What are the clinical implications of this work?: The strategies and materials evaluated in this study could be used in clinical practice with people with aphasia. In order to replicate treatment effects in clinical practice, we suggest applying the strategy combination with the same protocol features (e.g., frequency, duration, homework, product orientation) as in this study, implementing Intervention Micro and Intervention Macro sequentially in either order. As treatment response was not equal in all individuals, it seems important to investigate individual features that contribute to treatment success. [ABSTRACT FROM AUTHOR]

Background: Although research on mathematics learning programs has taken off in recent years, little is known about how different person characteristics are related to practice behaviour with such programs. When implementing a mathematics learning program in the classroom, it might be important to know whether students with specific characteristics need more encouragement to make use of this learning opportunity. Objectives: Using a supply‐use model, we analysed the predictive power of students' cognitive characteristics (prior mathematics knowledge), personality traits (conscientiousness), motivational‐affective characteristics (mathematics self‐concept and mathematics anxiety), and family background characteristics (socioeconomic status and migration background) for practising with an adaptive arithmetic learning program. Methods: We used longitudinal data from 203 fifth graders from seven non‐academic‐track schools in Germany. Practice behaviour, measured by completed tasks in the learning program, was recorded weekly for every student over a period of 22 weeks. Results and Conclusions: The results of our multilevel analyses showed that mathematics anxious students practised less with the program. We did not find any relationship with the other characteristics. Takeaways: Our results suggest that mathematics anxious students need more encouragement when practising with a mathematics learning program; otherwise, they do not get the chance to benefit from the use. Lay Description: What is already known about this topic: The use of mathematics learning programmes in mathematics education has recently intensified.It is important that students practice with such learning programmes regularly over a longer period of time in order for them to achieve learning success.Students differ in their mathematics learning behaviour. What this paper adds: Little is known about how person characteristics are related to practice behaviour with mathematics learning programmes.Students may differ in their use of a mathematics learning programme, which is why cognitive characteristics, personality traits, motivational‐affective characteristics, and family background characteristics may affect students' practice behaviour. Implications for practice: Mathematics anxious students practiced less with a mathematics learning program, and need more encouragement to benefit equally from the implementation in school.Teachers should keep in mind that after the initial enthusiasm, practice with a programme may decrease over time, especially after school holidays. [ABSTRACT FROM AUTHOR]

Background: Formative assessments are needed to enable monitoring how student knowledge develops throughout a unit. Constructed response items which require learners to formulate their own free‐text responses are well suited for testing their active knowledge. However, assessing such constructed responses in an automated fashion is a complex task and requires the application of natural language processing methodology. In this article, we implement and evaluate multiple machine learning models for coding energy knowledge in free‐text responses of German K‐12 students to items in formative science assessments which were conducted during synchronous online learning sessions. Dataset: The dataset we collected for this purpose consists of German constructed responses from 38 different items dealing with aspects of energy such as manifestation and transformation. The units and items were implemented with the help of project‐based pedagogy and evidence‐centered design, and the responses were coded for seven core ideas concerning the manifestation and transformation of energy. The data was collected from students in seventh, eighth and ninth grade. Methodology: We train various transformer‐ and feature‐based models and compare their ability to recognize the respective ideas in students' writing. Moreover, as domain knowledge and its development can be formally modeled through knowledge networks, we evaluate how well the detection of the ideas within responses translated into accurate co‐occurrence‐based knowledge networks. Finally, in terms of the descriptive accuracy of our models, we inspect what features played a role for which prediction outcome and if the models pick up on undesired shortcuts. In addition to this, we analyze how much the models match human coders in what evidence within responses they consider important for their coding decisions. Results: A model based on a modified GBERT‐large can achieve the overall most promising results, although descriptive accuracy varies much more than predictive accuracy for the different ideas assessed. For reasons of comparability, we also evaluate the same machine learning architecture using the SciEntsBank 3‐Way benchmark with an English RoBERTa‐large model, where it achieves state‐of‐the‐art results in two out of three evaluation categories. Lay Description: What is already known about this topic?: Formative assessments are needed to test and monitor the development of learners' knowledge throughout a unit to provide them with appropriate automated feedback.Constructed response items which require learners to formulate their own free‐text responses are well suited for testing their active knowledge.Assessing constructed responses in an automated fashion is a widely researched topic, but the problem is far from solved and most of the work focuses on predicting holistic scores or grades.To allow for a more fine‐grained and analytic assessment of learners' knowledge, systems which go beyond predicting simple grades are required.To guarantee that models are stable and make their predictions for the correct reasons, methods for explaining the models are required. What this papers adds?: A core topic in physics education is the concept of energy.We implement and evaluate multiple systems based on natural language processing technology for assessing learners' conceptual knowledge about energy physics using transformer language models as well as feature‐based approaches.The systems assess students' knowledge about various forms of energy, indicators for the same and the transformation of energy from form into another.As our systems are based on machine learning methodology, we introduce a novel German short answer dataset for training them to detect the respective knowledge elements within students' free‐text responses.We evaluate the performance of these systems using this dataset as well as the well‐established SciEntsBand‐3‐Way dataset and manage to achieve, to our best knowledge, new state‐of‐the‐art results for the latter.Moreover, we apply methodology for explaining model predictions to assess whether predictions are carried out for the correct reasons. Implications for practice and/or policy: It is indeed possible to assess constructed responses for the demonstrated knowledge about energy physics in an analytic fashion using natural language processing.Transformer language models can outperform more specialized feature‐based approaches for this task in terms of predictive and descriptive accuracy.Co‐occurrences of different concepts within the same responses can lead models to learn undesired shortcuts which make them unstable. [ABSTRACT FROM AUTHOR]

Background: Computer‐based assessment allows for the monitoring of reader behaviour. The identification of patterns in this behaviour can provide insights that may be useful in informing educational interventions. Objectives: Our study aims to explore what different patterns of reading activity exist, and investigates their interpretation and consistency across different task sets (units), countries, and languages. Three patterns were expected: on‐task, exploring and disengaged. Methods: Using log data from the PISA 2012 digital reading assessment (9226 students from seven countries), we conducted hierarchical cluster analyses with typical process indicators of digital reading assessments. We identified different patterns and explored whether they remained consistent across different units. To validate the interpretation of the identified patterns, we examined their relationship to performance and student characteristics (gender, socio‐economic status, print reading skills). Results and Conclusions: The results indicate a small number of transnational clusters, with unit‐specific differences. Cluster interpretation is supported by associations with student characteristics—for example, students with low print reading skills were more likely to show a disengaged pattern than proficient readers. Exploring behaviour tended to be exhibited only once across the three units: It occurred in the first unit for proficient readers and in later units for less skilled readers. Major Takeaways: Behavioural patterns can be identified in digital reading tasks that may prove useful for educational monitoring and intervention. Although task situations are designed to evoke certain behaviours, the interpretation of observed behavioural patterns requires validation based on task requirements, assessment context and relationships to other available information. Lay Description: What is already known about the subject matter?: Students differ in how they read, comprehend and use digital information.Indicators from process data provide insight about how students engage with digital reading tasks. What does this paper add to the subject matter?: Based on multiple process indicators, a small number of clusters indicating different behavioural activity can be distinguished.These clusters can be described as on‐task, passive, hasty, exploring, disengaged, persistent and lost interest.A meaningful interpretation of the clusters must consider the requirements of the underlying tasks. Implications for practice and/or policy: Knowledge of how students engage with digital resources may provide useful feedback for teachers to guide students' learning or intervene when they struggle.Educational monitoring: The high comparability of country‐specific results suggests an invariant set of solution strategies in the digital reading assessment. [ABSTRACT FROM AUTHOR]

Background: Students often show unfavourable attribution: they attribute poor school performance to stable factors such as lack of ability and good school performance to variable factors such as effort. However, attribution can be influenced by individualized digital re‐attributional feedback leading to positive motivational effects and higher learning outcomes. This is very promising, but it still is unclear, whether this digital re‐attributional feedback can also be successfully integrated in everyday classroom activities. Objectives: The present field experiment investigated how integrating digital re‐attributional feedback into classroom instruction affects student attribution, motivation and learning outcomes. Methods: In the experiment, 8th–10th grade high school students (N = 322) worked with a digital mathematics learning program which was integrated in a three‐week teaching unit. Half the students in each classroom received only standard feedback after each practice task (SF group); the other half received additionally an individual re‐attributional feedback (RF group) after every third task. Attribution, mathematics self‐concept, and self‐efficacy were measured by an online questionnaire twice a week; learning outcomes in mathematics were measured weekly. Results and Conclusion: Hierarchical analyses showed that re‐attributional feedback led to a more favourable attribution in case of success on stable factors. Especially low‐performing students benefited from this feedback. No effects on attribution in case of failure, self‐efficacy or learning outcomes could be found. Further research could investigate if certain adaptations to the digital re‐attributional feedback is more effective in a real classroom setting and has a broader impact on different students. Lay Description: What is already known about this topic: Working with computers in the classroom and at home is becoming more common.Re‐attributional feedback can increase student's motivation when given directly after solving a task and at a high density.Digital re‐attributive feedback can be given in a high density.Re‐attributional training sessions have been shown to be effective in individual training sessions or outside the students' classroom. What this paper adds: The study took place within a real teaching environment during mathematics class for 4 weeks.Digital re‐attributional feedback sessions were directly integrated into the students' online learning which was part of the teaching plan. The implications of study findings for practitioners: Computer‐based re‐attributional training show some limited effects in regular classroom instruction and could be well integrated in student online learning—when adapted accordingly.Low‐performing students show less favourable attribution than better‐performing students in case of success and benefit the most from re‐attributional training. [ABSTRACT FROM AUTHOR]

Background: The professional knowledge of pre‐service teachers is highly important for effective and successful teaching. In recent years, many research groups have been engaged in developing simulated classroom environments to capture especially the pedagogical knowledge (PK) of pre‐service teachers, neglecting the content‐related facets of professional knowledge such as pedagogical content knowledge (PCK). Objectives: In the present study, we describe the development of a simulated classroom environment—the Simulated Classroom Biology (SCRBio)—and provide evidence regarding its validity to assess pre‐service biology teachers' action‐oriented PCK in the area of evolution. Methods: This study examined the evidence supporting the validity of using the SCRBio to investigate action‐oriented PCK of pre‐service biology teachers. The (1) evidence based on test content (expert ratings) and the (2) evidence based on relation to other variables (known‐groups comparison) was obtained. We tested the SCRBio with N = 76 German pre‐service biology teachers. Results and Conclusions: Our results show the successfully operationalized PCK in the SCRBio through explicit allocation of specific misconceptions to each virtual student's answer and the valid measurement of pre‐service biology teachers' action‐oriented PCK. This results in a validated simulated classroom environment for pre‐service but also in‐service teachers. In the future, the SCRBio will be developed from an assessment instrument to a training tool to simulate explicit teaching situations. This allows to complement the predominantly theoretical components of university‐based teacher education with practice‐based simulated classroom environments. Lay Description: What is already known about this topic: The professional knowledge of pre‐service teachers is a prerequisite for quality teaching in the future, as well as student achievement.Simulated classroom environments are already being used, primarily to examine and train the pedagogical knowledge of pre‐service teachers.The action‐oriented character of simulated classroom environments can bridge the theory‐practice gap of university‐based education programs. What this paper adds: Description of an innovative simulated classroom environment—the Simulated Classroom Biology.Ability to capture several domains of professional knowledge in an action‐oriented setting.Validation of the Simulated Classroom Biology using various validity aspects.Implications of study findings for practitioners.Description of validation steps for developing simulated classroom environments.A validated simulated classroom environment is provided to capture various knowledge domains of professional knowledge in an actionable setting.The Simulated Classroom Biology can be adapted to new subjects and teaching topics by changing the content. [ABSTRACT FROM AUTHOR]

The study presented in this paper aimed to examine the effect of visual and verbal cognitive style on learning from different types of visualization and modalities of explanatory text. Learning materials in the form of either computer‐based animation or a series of static pictures with written or spoken explanations were presented to 197 students. We found that a more developed visual cognitive style was related to a better learning outcome, when learning from a combination of static pictures and written text. Higher developed visualizers achieved poorer learning outcomes when learning with an animation and written text. The results are partially in line with an ability‐as‐compensator effect and the expertise reversal effect. Additionally, we found a modality effect as the versions with spoken text provided better results on learning outcome than the versions with written text regardless of the prominence of visual cognitive style. No significant interaction effects were found regarding verbal cognitive style. Lay Description: What is already known about this topic: Combining text and pictures supports learning and deepens understanding.Learning differs with respect to individual differences and the type of visualization.Visualizers profit from pictorial information more than verbalizers.Unclear what type of visualization and modality is beneficial to visualizers. What this paper adds: Influence of cognitive style on learning differs with regard to text modality.Visual cognitive style moderates multimedia learning with written text.Higher visual cognitive style leads to better learning with pictures and written text.Higher visual cognitive style leads to poorer learning with animations and written text. Implications for practice and/or policy: Contributes to empirical findings on how people learn from text and visuals.Broadens discussion on cognitive style and its impact on the learning process.Modality of the explanatory text has an impact on the learning outcome.Implement the written modality with caution during multimedia learning. [ABSTRACT FROM AUTHOR]

The impact of algorithms on everyday life is ever increasing. Medicine and public health are not excluded from this development – algorithms in medicine do not only challenge, change and inform research (methods) but also clinical situations. Given this development, questions arise concerning the competency level of prospective physicians, thus medical students, on algorithm related topics. This paper, based on a master's thesis in library and information science written at Humboldt‐Universität zu Berlin, gives an insight into this topic by presenting and analysing the results of a knowledge test conducted among medical students in Germany. F. J. [ABSTRACT FROM AUTHOR]

Physical fitness is an important health resource. From 2003 onwards, the MoMo study, a part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), has investigated physical fitness on the basis of nationally representative data. The objective of this paper was to analyse trends in physical fitness of three cohorts at the ages of 4–17 years. Changes within 10 test items of the MoMo-test profile are reported. The mean values of physical fitness and the relevant influencing factors were directly compared across cohorts (in the total group and in age-and sex-subgroups). Statistical significance of differences was examined by calculating the confidence intervals (95% CI) for complex samples; effect sizes were determined using Cohen's d. The results indicated that physical fitness levels of German children and adolescents initially slightly increased between MoMo baseline (2003–2006) and wave 1 (2009–2012). This could partly be attributed to increased physical activity in sports clubs and in extracurricular sports at school. Then, between MoMo wave 1 and MoMo wave 2 (2014–2017) the physical fitness of children and adolescents in Germany remained the same, as did all influencing factors with the exception of extracurricular sport. From a public health perspective, programmes and measures that can increase the chances for all children and adolescents to strive for greater physical fitness should be of the highest priority. [ABSTRACT FROM AUTHOR]

Stadium noise – created by spectators and fans – plays a critical part in the reality of professional sports. Due to a lack of research on the impact of these auditory cues and multimodal environments on motor performance, it is currently unclear how professional athletes experience and perceive stadium noise and how this potentially affects performance in practice. In order to explore the effect of stadium noise on athletes' performance, this paper presents an experimental design using the unique and standardised football training tool known as the "Footbonaut". Specifically, fifteen skilled German football players engaged in a standardised football-specific technical training programme while subjected to four different auditory training conditions; these included both "positive" and "negative" stadium noise conditions, a "baseline" condition providing auditory guidance, and a "no (auditory) cue" condition. Performance data for passing accuracy and passing time were measured for training in each auditory condition. A repeated measures MANOVA revealed a significant main effect for passing time. Specifically, participants showed faster passing times in the baseline compared to the negative and no auditory cue conditions. Findings are presented and discussed from a constraints-led perspective, allied to principles of ecological dynamics and nonlinear pedagogy. Particularly, the use of representative training experiences (including multimodal sensory and emotional information) appears to underline training to refine expert athletes' adaptive coordination of complex motor actions. [ABSTRACT FROM AUTHOR]

This paper examines the discretionary reasoning of the judiciary in three jurisdictions, England, Germany and Norway, in cases deciding whether a newborn child is safe with her parents or intervention is necessary. Our analysis focuses on one specific dimension of decision makers' exercise of discretion, namely, if and how the strengths and weaknesses of the mother are considered. The data material consists of all decisions concerning care orders of newborns from one large city in Germany from 2015 to 2017 (n = 27) and 2016 in Norway (n = 76) and all publicly available newborn removal decisions in England for 2015–2017 (n = 14). The findings reveal a high number of risk factors in the cases and less focus on risk‐reducing factors. The situation of the newborn is considered to be harmful, as most cases result in a care order. Judicial discretion differs by how much information, and what types of factors, are included in the justification for the decision. A learning point for decision makers and policymakers would be to actively undertake a balancing act between risk‐increasing and risk‐reducing factors. [ABSTRACT FROM AUTHOR]

Introduction: Regular moderate‐to‐vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults. Methods: Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X‐BT + accelerometers worn for 7 days. Self‐rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross‐sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment. Results: Substituting 30 minutes of SB with LPA (β −.37; 95% CI −0.42, −0.32) or MVPA (β −.14; 95% CI −0.21, −0.07) and substituting LPA with MVPA (β −.11; 95% CI −0.18, −0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β.55; 95% CI 0.49, 0.62) was associated with increased depression. Conclusion: Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA. [ABSTRACT FROM AUTHOR]

The diverse nature of 21st‐century organizations has compelled leaders to minimize discrimination and bring about inclusion amongst their employees. One of the ways this can be achieved is through authentic, respectful, and inclusive leadership. The aim of the present paper was to (1) explore whether the three leadership styles can promote inclusion and curtail discrimination in the South African context and (2) ascertain whether this relationship has any bearing on well‐being across Dutch, German, Icelandic, Indonesian, and South African contexts. To reach these aims, two cross‐sectional studies have been conducted. In Study 1, 569 employees were surveyed, and results indicated that all three leadership styles loaded on a common latent factor (positive leadership) that was positively associated with both inclusion and discrimination. In Study 2, 1,926 employees were surveyed across the five countries. Results indicated that once again, the latent, positive leadership factor was positively associated with both inclusion and discrimination. Furthermore, inclusion, when compared to discrimination seemed to be a stronger mediator in the relationship between positive leadership and well‐being. We propose leadership development that will cultivate positive leadership behaviors for the benefit of employee well‐being and collaboration in increasingly diverse teams. [ABSTRACT FROM AUTHOR]

A brief, problem-oriented phase such as an inventing activity is one potential instructional method for preparing learners not only cognitively but also motivationally for learning. Student teachers often need to overcome motivational barriers in order to use computer-based learning opportunities. In a preliminary experiment, we found that student teachers who were given paper-based course material spent more time on follow-up coursework than teachers who were given a well-developed computer-based learning environment (CBLE), leading to higher learning outcomes. Thus, we tested inventing as an instructional method that may help overcome motivational barriers of teachers' use of computer-supported tools or learning environments in our main experimental study (N = 44). As a computer-based environment, we used the 'Assessment of Learning strategies in Learning journals'. The inventing group produced ideas about criteria to evaluate learning strategies based on student cases prior to the learning phase. The control condition read a text containing possible answers to the inventing problem. The inventing activity enhanced motivation prior to the learning phase and assessment skills as assessed by transfer problems. Hence, the inventing activity prepared student teachers to learn from a CBLE in a motivational as well as cognitive way. [ABSTRACT FROM AUTHOR]

Understanding the nature of science ( NOS) is a critical aspect of scientific reasoning, yet few studies have investigated its developmental beginnings and initial structure. One contributing reason is the lack of an adequate instrument. Two studies assessed NOS understanding among third graders using a multiple-select ( MS) paper-and-pencil test. Study 1 investigated the validity of the MS test by presenting the items to 68 third graders (9-year-olds) and subsequently interviewing them on their underlying NOS conception of the items. All items were significantly related between formats, indicating that the test was valid. Study 2 applied the same instrument to a larger sample of 243 third graders, and their performance was compared to a multiple-choice ( MC) version of the test. Although the MC format inflated the guessing probability, there was a significant relation between the two formats. In summary, the MS format was a valid method revealing third graders' NOS understanding, thereby representing an economical test instrument. A latent class analysis identified three groups of children with expertise in qualitatively different aspects of NOS, suggesting that there is not a single common starting point for the development of NOS understanding; instead, multiple developmental pathways may exist. [ABSTRACT FROM AUTHOR]

Despite the great emphasis organizations and human resource management (HRM) research place on turnover issues, one turnover phenomenon has received only limited attention so far: joint leader–member turnover. This research examines supervisor‐initiated turnover (SIT) (i.e., employees' decision to quit their employer to follow a former supervisor to a new organization) and develops a comprehensive model of the SIT decision process, grounded on conservation of resources (COR) theory, that delineates the resource evaluation, conservation and investment deliberations of employees. We take a relational perspective and particularly focus on the leader–member relationship as an important antecedent of SIT and thereby respond to the call for more critical investigations of leader–member exchange (LMX) and corresponding HRM implications. Our three studies (survey, scenario experiment, and dyadic interview study) demonstrate that LMX positively affects SIT intentions (SITI) and that supervisor commitment represents an important mediating mechanism of the LMX–SITI relationship. Our interview study with 46 leader–member dyads identifies relational factors that promote or hinder SIT beyond the leader–member relationship. We discuss the theoretical contributions and practical implications for HRM. [ABSTRACT FROM AUTHOR]

ABSTRACT Research on ideological attitudes has identified two main dimensions that refer to two fundamental features of group organization: social solidarity and social control. In response to prior research that has studied their relationship mainly from a correlational perspective, this paper introduces a social reality model based on psychological functionality of ideological attitudes. Social position variables (education, income and material vulnerability) and insecurity variables (fear of crime and distrust) are used to predict the interplay between ideological attitudes towards social solidarity and social control. Using K-means cluster analysis, a typology with four patterns of support for solidarity and control ('socials', 'repressives', 'minimalists' and 'social-repressives') was created, on the basis of representative survey data for the UK, France and Germany ( N = 7034). Results from logistic regression analyses show that the proposed social reality model explains membership in typology categories, with similar results across the three countries. Overall, the model underscores the social origins of ideological attitudes as functional responses to perceived social reality. The paper illustrates how the social psychological study of ideological attitudes may be enriched by a typological approach that examines patterns of attitudes rather than single dimensions. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims and objectives: Pressure ulcers (PUs) are a serious health problem. They can be considered as an indicator of the quality of health care and are associated with considerable cost increases for the health care system. The prevention of PUs is a major concern in hospital care. The aim of the study was to reveal the current PU prevention‐related processes and structures with a specific focus on the Accident and Emergency (A&E) Department. Method: In late 2018/early 2019, all German hospitals were invited to participate in a nationwide cross‐sectional survey. One standardized questionnaire was assigned to a representative of each hospital. The representative was asked to state what PU‐related structures and processes are implemented in their hospital, in general and specific to the A&E department. Besides mostly descriptive analysis, PU‐related processes were analysed on PU incidence in a multivariate linear regression model. Results: Two hundred seventy‐six hospitals participated in the survey. 63.4% (n = 175) of the participating hospitals had at least one PU manager. Skin inspection was the most frequently performed procedure. Although not recommended, 1.3% (2.1%) of the facilities still use sheepskins quite often (very often). In the regression model on PU incidence, only the process 'mobilization in bed' was statistically significantly associated. Although the risk of developing a PU in the emergency department is high, more than half of the facilities had no PU guidelines. Conclusion: Even if recommended procedures (skin inspection, 30° positioning) have been used frequently, regular training could help to bring new scientific findings such as the use of local skin protection dressings into clinical practice. Prevention guidelines should be established in all areas of care even for A&E as well as when patients are transferred inside or out of the hospital, where the risk of PU development was considered low. [ABSTRACT FROM AUTHOR]

Drawing from team‐level job demands‐resources theory, we hypothesize that team workload demands moderate the positive link between team boundary work (i.e., boundary spanning and boundary buffering) and team effectiveness (i.e., team innovation and team performance), such that boundary work is more beneficial for team effectiveness when teams face higher team workload demands. Furthermore, we predict that this interaction occurs through increased team vigor, where team vigor is defined as an affective emergent state characterized by positive valences and high activation levels experienced by team members. We largely find support for our model across two field studies: a cross‐sectional survey using three independent data sources (89 automotive research and development teams, including 724 team members, 89 team leaders and 18 managers) and a time‐lagged survey using two independent data sources (139 teams working in a Chinese utility company, including 640 team members and 139 team leaders). Our article contributes to team research by broadening our understanding of when and how team boundary work is associated with greater team effectiveness. [ABSTRACT FROM AUTHOR]

The secular trend of reduced physical fitness (PF) leads to increased health risks. The aim of the present paper is to analyse various current factors that affect health behaviour with respect to the course of PF over 2 years. A path analysis combined with a latent growth curve analysis was based on a study that was conducted between June 2008 and June 2010 with 145 primary German school children (52.1% male, average age at baseline 7.95 years ± 0.95). PF was tested with the German Motor Test 6–18. For the mean PF and the course of PF, direct and indirect influences were shown over three levels, including migration background on the first level and physical activity (PA) on the second level. Body mass index (BMI) impacted the mean PF but not the course of PF. The influence of sedentary behaviour on the mean PF was diminished (compared to bivariate analysis) due to its common variance mainly with BMI. PA affected not only current PF in children but also the course of PF (aintercept =.28, P =.001; aslope =.27, P =.21). Consequently, preventive measures should focus on early adoption and maintenance of PA. [ABSTRACT FROM AUTHOR]

This paper examines the contribution of incompleteness/'not just right experiences' (NJREs) to an understanding of the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality traits (OCPTs). It investigates the association of specific OCD symptom dimensions with OCPTs, conceptualized as continuous phenomena that are also observable below the diagnostic threshold. As empirical findings and clinical observation suggest that incompleteness feelings/NJREs may play a significant affective and motivational role for certain OCD subtypes, but also for patients with accentuated OCPTs, we hypothesized that OCPTs are selectively linked with incompleteness-associated OCD symptom dimensions (ordering, checking, hoarding and counting). Moreover, we assumed that this selective relationship cannot be demonstrated any more after statistical control of incompleteness, whereas it is preserved after statistical control of anxiety, depression, pathological worry and harm avoidance. Results from a study with a large clinical sample ( n = 185) partially support these hypotheses and suggest that NJREs may be an important connecting link between specific OCD symptom dimensions, in particular ordering and checking, and accentuated OCPTs. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Obsessive-compulsive personality traits (OCPTs) are positively related to obsessive-compulsive disorder symptom dimensions (ordering, checking, hoarding and counting) hypothesized or found to be associated with incompleteness/'not just right experiences' (NJREs), but not to washing and obsessions., This positive relationship, which is strongest for ordering and checking, is eliminated when NJREs are statistically controlled., Ordering, checking and accentuated OCPTs may share NJREs as a common affective-motivational underpinning., Dysfunctional behaviour patterns of people with accentuated OCPTs or obsessive-compulsive personality disorder (OCPD) may be viewed as efforts to avoid or reduce subjectively intolerable NJREs., On the basis of such a conceptualization of OCPD as an emotional disorder, a novel treatment approach for OCPD focusing on habituation to NJREs could be developed. [ABSTRACT FROM AUTHOR]

Context Basic science teaching in undergraduate medical education faces several challenges. One prominent discussion is focused on the relevance of biomedical knowledge to the development and integration of clinical knowledge. Although the value of basic science knowledge is generally emphasised, theoretical positions on the relative role of this knowledge and the optimal approach to its instruction differ. The present paper addresses whether and to what extent biomedical knowledge is related to the development of clinical knowledge. Methods We analysed repeated-measures data for performances on basic science and clinical knowledge assessments. A sample of 598 medical students on a traditional curriculum participated in the study. The entire study covered a developmental phase of 2 years of medical education. Structural equation modelling was used to analyse the temporal relationship between biomedical knowledge and the acquisition of clinical knowledge. Results At the point at which formal basic science education ends and clinical training begins, students show the highest levels of biomedical knowledge. The present data suggest a decline in basic science knowledge that is complemented by a growth in clinical knowledge. Statistical comparison of several structural equation models revealed that the model to best explain the data specified unidirectional relationships between earlier states of biomedical knowledge and subsequent changes in clinical knowledge. However, the parameter estimates indicate that this association is negative. Discussion Our analysis suggests a negative relationship between earlier levels of basic science knowledge and subsequent gains in clinical knowledge. We discuss the limitations of the present study, such as the educational context in which it was conducted and its non-experimental nature. Although the present results do not necessarily contradict the relevance of basic sciences, we speculate on mechanisms that might be related to our findings. We conclude that our results hint at possibly critical issues in basic science education that have been rarely addressed thus far. [ABSTRACT FROM AUTHOR]

ABSTRACT The paper examined the effect of positive beliefs about the value of ethnic diversity (i.e. diversity beliefs) on discrimination due to foreign sounding names. It was hypothesized that pro-diversity beliefs reduce discrimination. Results from two studies (N = 29 and N = 104) confirmed this hypothesis. Practical implications of our results are discussed. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper examines the role of the belief in a just world as a personal resource when people are faced with the adverse consequences of inflation and financial crises by presenting results from two longitudinal studies. The first study, based on responses from 262 German residents, found that participants with a strong personal belief in a just world perceived a lower economic impact in light of price increases following a tax increase. This effect remained stable after controlling for the socioeconomic variables of gender, age, household income, and education. The second study, based on a sample of 177 German residents, found that residents with a strong personal belief in a just world perceived a lower economic impact in light of the global subprime mortgage crisis. Again, this effect remained stable after controlling for the socioeconomic variables of gender, age, household income, and education. Furthermore, the personal belief in a just world influenced perceived economic impact over time and the relationship between personal belief in a just world and perceived economic impact was partially mediated by differences between life satisfaction in the future as measured in a first wave and current life satisfaction as measured in a second wave. [ABSTRACT FROM AUTHOR]

Applying social identity theory and the relational demography approach, this paper proposes that the effect of age diversity on individual team members' health is contingent on the individual age as well as on age stereotypes. We suggest that younger and older employees' health is negatively associated with age diversity, while middle-aged team members' health is not affected. We further postulate that age stereotypes strengthen the negative effect of age diversity for the younger age group, while they weaken the effect for older employees. For middle-aged team members, age stereotypes are expected not to determine the relationship between age diversity and health. We tested our hypotheses based on data from a representative sample of the German workforce ( n = 1,214). The results fully confirmed our hypotheses. Practitioner Points Organizations have to be aware that age diversity can undermine the health of older and younger team members., We found that younger team members' health is only affected by working in age-diverse teams if they hold negative stereotypical views about older team colleagues. In contrast, older team members' health is only affected if they do not hold negative stereotypical views about older employees., Accordingly, we advise taking steps to reduce the age stereotypes of younger team members in age-diverse teams. [ABSTRACT FROM AUTHOR]

Recognizing the ageing of populations and expected increase in prevalence of dementia, the necessity of research involving persons with dementia is widely agreed upon. Autonomy is key to nursing home residents' well-being and quality of life, but this phenomenon has not been thoroughly assessed from the residents' perspective. The aim of this cross-sectional study was to investigate perceived autonomy of nursing home residents. Data on 560 randomly selected residents in 40 nursing homes in two German federal states were generated by face-to-face interviews, psychological and physical assessments, analysis of nursing records, and acquisition of institutional parameters. This paper reports on a subsample ( n = 179) that met screening requirements, including subjects with and without mild cognitive impairment ( Mini Mental Status Examination score 30-18), who completed the Hertz Perceived Enactment of Autonomy Scale ( HPEAS). The mean score of HPEAS was 101.1 ± 14.5 (range 54-122). In our population, Cronbach's alpha was 0.89. Scores in HPEAS were not related to demographical factors but positively associated with increasing self-efficacy and absence of pain. The novel findings contribute to an understanding of autonomy from the residents' perspective. [ABSTRACT FROM AUTHOR]

The present paper extends the needs-based model of reconciliation to contexts marked by status inequalities rather than by overt intergroup aggression. Specifically, we investigated whether and when members of high-status versus low-status groups experience divergent socio-emotional needs vis-à-vis members of the respective other status group. Building on research informed by social identity theory, we hypothesized that the groups' different positions in the social hierarchy only translate into divergent needs when the status differences are perceived as illegitimate. In Study 1 (N = 130), we tested this prediction by manipulating status and perceived legitimacy of status differences in a setting with artificially created groups. Results confirmed that the need to be socially accepted by members of the other status group was stronger in high-status compared with low-status group members but, as expected, only when the status differences were perceived to be illegitimate. Also as predicted, the need to be empowered by the other status group was stronger in low-status compared with high-status group members, again only under conditions of illegitimate status differences. Study 2 (N = 169) further corroborated our perspective by replicating these findings in a naturalistic intergroup context. Implications for the role of legitimacy perceptions in determining differential socio-emotional needs and for the promotion of sustainable social change are discussed. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Objective: The capacity of individuals with anorexia nervosa (AN) to forgo immediate food rewards in their long‐term pursuit of thinness is thought to reflect elevated self‐control and/or abnormal reward sensitivity. Prior research attempted to capture an increased tendency to delay gratification in AN using delay‐discounting tasks that assess how rapidly the subjective value of rewards decreases as a function of time until receipt. However, significant effects were mostly subtle or absent. Here, we tested whether the process leading to such decisions might be altered in AN. Method: We recorded mouse‐cursor movement trajectories leading to the final choice in a computerized delay‐discounting task (238 trials) in 55 acutely underweight females with AN and pairwise age‐matched female healthy controls (HC). We tested for group differences in deviations from a direct choice path, a measure of conflict strength in decision making, and whether group moderated the effect of several predictors of conflict strength (e.g., choice difficulty, consistency). We also explored reaction times and changes in trajectory directions (X‐flips). Results: No group differences in delay‐discounting parameters or movement trajectories were detected. However, the effect of the aforementioned predictors on deviations (and to a lesser extent reaction times) was reduced in AN. Discussion: These findings suggest that while delay discounting and conflict strength in decision making are generally unaltered in AN, conflict strength was more stable across different decisions in the disorder. This might enable individuals with AN to pursue (maladaptive) long‐term body‐weight goals, because particularly conflicting choices may not be experienced as such. Public Significance: The deviations from a direct path of mouse‐cursor movements during a computerized delay‐discounting task varied less in people with anorexia nervosa. Assuming such deviations measure decision conflict, we speculate that this increased stability might help people with anorexia nervosa achieve their long‐term weight goals, as for them the struggle with the decision to eat high‐calorie meals when hungry will be milder, so they would be more likely to skip them. [ABSTRACT FROM AUTHOR]

Background: Previous studies have yielded mixed results on the association between gender and alcohol use disorder (AUD) treatment outcomes. Thus, additional research is needed to determine the effect of gender on AUD treatment outcomes, including quality of life (QoL), particularly among older adults. Aims: In a clinical sample of older adults with DSM‐5 AUD, we examined changes in QoL from the beginning of AUD treatment through 1 year of follow‐ups. We also examined the effect of gender and explored interaction effects with gender on QoL. Methods: We utilized data from the "Elderly Study," a multi‐national, single‐blind, randomized, controlled trial of 693 adults aged 60+ with DSM‐5 AUD. Alcohol use was assessed with the Form‐90, and QoL with the brief version of the World Health Organization QoL measure. Information was collected at treatment initiation and at 4‐, 12‐, 26‐, and 52‐week follow‐ups. Multilevel mixed‐effects logistic and linear regression models were used to examine QoL changes and the effect of gender on changes in QoL. Results: Following treatment, small, but significant improvements were seen over time in overall perceived health (p < 0.05). Improvements that persisted over the 1‐year follow‐up period were seen in the QoL domains of physical health (β: 2.6, 95% CI: 1.4–3.9), psychological health (β: 3.5, 95% CI: 3.3–3.8), social relationships (β: 4.0, 95% CI: 2.5–5.6), and environmental health (β: 1.4, 95% CI: 0.4–2.4). No significant changes were seen over time in overall perceived QoL (p = 0.58). Gender was not associated with changes in any of the QoL outcome measures (all p ≥ 0.05). Conclusions: Among 60+ year‐old adults receiving treatment for DSM‐5 AUD, improvements in QoL were achievable and maintained over time, but were not associated with gender. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore psychosocial consequences of (false) positive liver screening results and to identify influencing factors for perceived strain within a multistage screening programme for liver cirrhosis and fibrosis in Germany. Methods: Between June 2018 and May 2019, all positively screened patients were asked to participate in the study (n = 158). N = 11 telephone interviews and n = 4 follow‐up interviews were conducted. Semi‐structured telephone interviews were carried out. The analysis followed a structuring content analysis approach. Thereby, categories were first defined deductively. Second, the categories were revised inductively based on the data. Results: The main themes found regarding the consequences of the screening were categorised in emotional reactions and behavioural reactions. Few respondents described negative emotional consequences related to screening. Those seem to be mostly driven by suboptimal patient–provider communication and might be worsened when transparent information transfer fails to happen. As a result, patients sought information and support in their social environment. All patients reported positive attitudes towards liver screening. Conclusion: To reduce the potential occurrence of psychosocial consequences during the screening process, medical screening should be performed in the context of transparent information. Regular health communication on the side of health professionals and increasing patients' health literacy might contribute to avoiding negative emotions in line with screening. Patient or Public Contribution: This study recognises the wide‐ranging patients' perspectives regarding the consequences of liver screening which should be taken into consideration when implementing a new screening programme to ensure a patient‐centred approach. [ABSTRACT FROM AUTHOR]

Membership of multiple groups and identification with those groups have been found to be positively related to individuals' health and well‐being. The present research sought to replicate this finding in two large, representative samples. Moreover, we sought to extend previous work by shedding light on the mechanisms mediating the effects of multiple group membership on positive health outcomes. Specifically, we proposed that the links between multiple group membership and positive health outcomes are mediated by reduced feelings of loneliness. In Study 1, a two‐wave survey of a German population, participants (N = 989) were asked about their identification with family, friends, neighbourhood, their country and humanity and 4 weeks later about feelings of loneliness, physical health and stress. As hypothesized, multiple identifications predicted lower stress. They were also associated with a marginal reduction in physical symptoms of poor health. Both relationships were mediated by the absence of loneliness. In Study 2, we conducted a cross‐sectional survey of German participants (N = 1635), which also included a sixth target of identification (Europe). Results replicated findings from Study 1 and also found similar relations associated with smaller (family, friends and neighbourhood) versus larger (country, Europe and Humanity) foci of identification. [ABSTRACT FROM AUTHOR]

Aims: Aim of the current study was to describe the prevalence, incidence, and severity of diabetes mellitus type 2 (T2D) in a cohort of older men and women aged 60 years and above over the course of on average 7 years, since longitudinal data on this topic are scarce for this age group in Germany. Methods: Baseline data of 1671 participants of the Berlin Aging Study II (BASE‐II; 68.8 ± 3.7 years) and follow‐up data assessed 7.4 ± 1.5 years later were analysed. The BASE‐II is an exploratory, observational study on cross‐sectional and longitudinal data of an older population. T2D was diagnosed based on self‐report, antidiabetic medication use and laboratory parameters. T2D severity was determined by the diabetes complications severity index (DCSI). Prognostic capacity of laboratory parameters was evaluated. Results: The proportion of participants with T2D increased from 12.9% (37.3% women) at baseline to 17.1% (41.1% women) with 74 incident cases and 22.2% not being aware of the disease at follow‐up. The incidence rate is 10.7 new T2D diagnoses per 1000 person‐years. More than half of the 41 newly identified incident T2D cases were diagnosed solely by the 2 h‐plasma glucose test (OGTT) and diagnosis based on OGTT as the only criterion among incident cases was found more frequently in women (p = 0.028). T2D severity expressed by the DCSI significantly increased from baseline to follow‐up (mean DCSI 1.1 ± 1.2 vs. 2.0 ± 1.8; range 0–5 vs. 0–6). Cardiovascular complications had the highest impact (43.2% at baseline and 67.6% at follow‐up). Conclusions: A comprehensive picture of T2D with respect to prevalence, incidence, and severity in older people of the Berlin Aging Study II is provided. [ABSTRACT FROM AUTHOR]

Etiological theories on the development of psychopathology often incorporate adverse childhood experiences (ACE) as an important contributing factor. Recent studies suggest personality functioning (PF; i.e., stability of the self and interpersonal relationships) as an important transdiagnostic construct that could be useful in better understanding when persons with ACE do (not) develop psychopathological symptoms. A representative sample of N = 2363 was assessed by questionnaires on ACE, PF (Level of Personality Functioning Scale—Brief Form 2.0), and current symptoms of depression, anxiety, and somatization (Brief Symptom Inventory 18). The interaction between ACE and PF on symptoms was investigated using multiple group models and Bayesian structural equation modeling. ACE were positively associated with psychopathology and PF impairments. The interaction effect between ACE and PF explained incremental variance in current symptoms, ranging from 26% for somatization to 49% for depression with the complete model explaining up to 91% of the latent variance in psychopathology. Our findings indicate a diathesis–stress model with PF as a resource or resilience that may buffer against the development of symptoms in the face of adversity. Treatments of depression and anxiety targeting self and interpersonal functioning therefore may lead to improvements in resilience and relapse prevention. [Correction added on 15 March 2023, after first online publication: Level of Personality Functioning Scale—Brief Form has been replaced to Level of Personality Functioning Scale—Brief Form 2.0 ] [ABSTRACT FROM AUTHOR]

Objectives: To develop a patient's attitude questionnaire regarding prevention in oral health for use internationally. Methods: Using a mixed methods approach, a questionnaire was developed and refined as part of ADVOCATE (Added Value for Oral Care) study, involving partners in six countries: Netherlands, Hungary, Denmark, Ireland, Germany, and the UK. A literature review explored the history of oral healthcare delivery systems to develop a template for each of the six ADVOCATE countries. A systematic review identified the perceived barriers and facilitators to preventive oral healthcare and underpinned a topic guide and established the patient questionnaire domains. Focus groups in each ADVOCATE country developed the first version of the questionnaire. Patient and Public Involvement and Engagement (PPIE) in each ADVOCATE country tested the questionnaire and led to further refinement. The questionnaire was produced in five languages. Content validity and reproducibility used principal component analysis (PCA) and exploratory factor analysis (EFA) refined the questionnaire. Results: The literature review aided an understanding of each country's oral healthcare system, and the findings from the 25 studies identified in the systematic review found the main barriers/facilitators to preventive oral healthcare were cost, knowledge (preventive treatments and advice), and a patient awareness and adherence to preventive advice/treatments. Interviews and focus groups with 148 participants in the ADVOCATE study identified receiving the appropriate level of care/feeling valued, cost, level of motivation/priority, not feeling informed, knowledge, and skill mix as the main barriers/facilitators. Fifty‐three PPIE members refined the questionnaire. The pilot questionnaire was tested with 160 participants. Non‐essential or highly correlated variables were then removed, leaving 38 items, covering 6 domains (cost, advice received, advice wanted, message delivery, motivation, knowledge, and responsibility) within the questionnaire. A second pilot test‐run was undertaken with 185 participants. The test‐re‐test reliability demonstrated strong consistency of responses between the two time points (kappa range 0.3–0.7, most p <.0011), which culminated with a final version of the Patient Attitudes to Prevention in Oral Health Questionnaire (PAPOH) questionnaire. Conclusions: This mixed‐methods approach enabled the development of a multi‐language attitudinal questionnaire for use with patients (PAPOH) to compare attitudes to oral disease prevention internationally. [ABSTRACT FROM AUTHOR]

Background: Regulatory problems (RPs; excessive crying, sleeping, or feeding difficulties) that co‐occur (i.e., multiple) or are persistent have been associated with cognitive and behavioral problems in childhood. However, it remains unknown if multiple or persistent RPs are associated with cognitive and behavioral problems in adulthood. Methods: This large prospective longitudinal study (N = 759) was conducted in two cohorts in Germany (N = 342) and Finland (N = 417). RPs were assessed at 5, 20, and 56 months via the same standardized parental interviews and neurological examinations. In young adulthood, questionnaires were used to assess behavioral problems. Cognitive functioning was assessed with IQ tests. We examined the effects of multiple or persistent RPs on the outcomes via analysis of covariance tests and logistic regression controlled for the influence of cohort. Results: Of 163 participants with RPs, 89 had multiple and 77 had persistent RPs. Adults who had early multiple or persistent RPs (N = 151) reported more internalizing (p =.001), externalizing (p =.020), and total behavioral problems (p =.001), and, specifically, more depressive (p =.012), somatic (p =.005), avoidant personality (p <.001), and antisocial personality problems (p =.006) than those who never had RPs (N = 596). Participants with multiple or persistent RPs were more likely to receive any ADHD diagnoses (p =.017), particularly of hyperactive/impulsive subtype (p =.032). In contrast, there were no associations between multiple or persistent RPs and IQ scores in young adulthood. Conclusions: The results indicate long‐lasting associations between multiple or persistent RPs and behavioral problems. Thus, screening for early RPs could help to identify children who are at risk for later behavioral problems. [ABSTRACT FROM AUTHOR]

Objectives: Decision aids (DAs) are promising tools to foster evidence‐based shared decision‐making between practitioners and service users. Nevertheless, it is still obscure how an evidence‐based DA for people with severe mental illness, especially psychosis, should look in an inpatient treatment setting to be useful and feasible. Therefore, we conducted focus groups with psychiatrists and service users to collect and assess their expectations and wishes regarding an evidence‐based DA. From these findings, we derived immediate recommendations for the future development of DAs. Methods: We held two group interviews with service users (n = 8) and three group interviews with psychiatrists (n = 10). We used an open, large‐scale topic guide. First, we presented data from a current meta‐analysis on antipsychotics to the interviewees and, in a second step, asked for their expectations and wishes towards a DA that integrates these data. Results: Our thematic analysis revealed six key themes addressed by the respondents: (1) general considerations on the importance and usefulness of such a DA, (2) critical comments on psychiatry and psychopharmacotherapy, (3) communicative prerequisites for the use of a DA, (4) form and content of the DA, (5) data input, data processing and output as well as (6) application of the DA and possible obstacles. Conclusions: Participants identified several important features for the development of DAs for selecting antipsychotics in inpatient psychiatric treatment. The digital format was met with the greatest approval. Especially the adaptability to different needs, users and psychopathologies and the possibility to outsource information dissemination via app seemed to be a decisive convincing argument. Further research is required to test specific features of DAs to be developed in clinical settings. Patient or Public Contribution: The entire project is supported by an advisory board, including also experienced users. The members are regularly updated about the process and give important feedback. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' and nurse assistants' experiences of providing end‐of‐life care during the COVID‐19 pandemic in Austria, Germany and Northern Italy. Design: A qualitative explorative interview study. Method: Data were collected between August and December 2020 and analysed using content analysis. Healthcare professionals (nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5)) from hospitals (n = 32) and long‐term care facilities (n = 9) in Austria, Germany and Northern Italy were interviewed for this study. Results: Five main categories were identified as follows: (i) end‐of‐life care involves love and duty, (ii) last wishes and dignity of the patient, (iii) communication with the family, (iv) organizational and religious aspects and (v) personal emotions. Results indicate that more training and guidelines are needed to prepare nurses and nurse assistants for end‐of‐life care during pandemics. Public contribution: This research can help prepare nurses and nurse assistants for end‐of‐life care in pandemics and will be of value for improving the institutional and government health policies. Furthermore, it can be of value in preparing training for healthcare professionals patient–relatives. [ABSTRACT FROM AUTHOR]

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross‐country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment‐oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere. [ABSTRACT FROM AUTHOR]

Background: Since May 2022, increasing numbers of monkeypox virus (MPXV) infections have been reported from across Europe and North America. Studies, mainly from Africa, have suggested a higher risk for severe MPXV cases in people living with HIV. Methods: This was a retrospective study of all confirmed MPXV infections observed in the participating centres since 19 May 2022. We conducted a chart review to evaluate clinical characteristics, comorbidities, and coinfections, including HIV, viral hepatitis, and sexually transmitted infections (STIs). Results: By 30 June 2022, a total of 546 MPXV infections were reported from 42 German centres. All patients were men who have sex with men (MSM), of whom 256 (46.9%) were living with HIV, mostly with a preserved immune system and with viral suppression. In total, 232 (42.5%) MSM were also taking HIV pre‐exposure prophylaxis (PrEP) and 58 (10.6%) MSM had no known HIV infection or PrEP use. The median age was 39 years (range 20–67), and comorbidities were rare. However, 52.4% and 29.4% of all patients had been diagnosed with at least one STI within the last 6 months or within the last 4 weeks, respectively. The most frequent localizations of MPXV infection were genital (49.9%) and anal (47.9%), whereas fever (53.2%) and lymphadenopathy (42.6%) were the most frequent general symptoms. The hospitalization rate was low (4.0%), and no fatal course was observed. The clinical picture showed no apparent differences between MSM with or without HIV. Conclusions: In this preliminary cohort analysis from a current large outbreak among MSM in Germany, the clinical picture of MPXV infection did not differ between MSM with and without HIV infection. Severe courses were rare and hospitalization rates were low. However, most patients were relatively healthy, and only a few people living with HIV were viremic or severely immunosuppressed. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic constitutes a prolonged global crisis, but its effects on mental health seem inconsistent. This inconsistency highlights the importance of considering the differential impact of the pandemic on individuals. There is some evidence that mental health trajectories are heterogeneous and that both sociodemographic and personal characteristics are associated with higher risk for mental health issues. By contrast, information on the role of social factors as potential determinants of initial reactions to the pandemic and on heterogeneous trajectories over time is lacking. We analysed seven assessments of a large‐scale (N = 2203) longitudinal study across 1.5 years, beginning in March 2020. Using self‐report data on mental health and life satisfaction, we applied latent change models to examine initial reactions and mean changes across the pandemic. In addition, we applied latent class growth analyses to investigate whether there were distinct groups with different patterns of change. Results showed that on average, levels of life satisfaction and anxiety decreased (d = −0.31 and d = −0.11, respectively), levels of depressive symptoms increased (d = 0.13), and stress levels remained unchanged (d = −0.01) during the first year of the pandemic. For each outcome, we identified four distinct mental health trajectories. Between 5% (for anxiety) and 11% (for life satisfaction) of the sample reported consistently high—and even increasing—impairments in mental health and well‐being. The trajectories of a sizeable number of people covaried with the course of the pandemic, such that people experienced better mental health when the number of COVID cases was low and when fewer restrictions were placed on public life. Low emotional support, high instrumental support, and the tendency to compare oneself with others were associated with more mental health issues. Findings show that whereas a substantial portion of people were largely unaffected by the pandemic, some individuals experienced consistently high levels of psychological distress. Social factors appear to play a crucial role in the maintenance of well‐being. [ABSTRACT FROM AUTHOR]

We argue that proactive work behavior's future orientation allows individuals to establish a connection with the future and thus to experience their work as meaningful. We further expect that this effect is enhanced when individuals are faced with an unpredictability of the future in their core job. We tested our hypotheses in three independent studies with employees. We first established the effect of proactive work behavior on work meaningfulness in a scenario‐based experiment (n = 140). A second experiment (n = 116) replicated this and also demonstrated that the effect was not driven by the benefits of proactive work behavior to others. A daily diary study (n = 107, k = 391) showed that day‐level proactive work behavior was positively associated with daily work meaningfulness and that this effect was again independent from having benefitted others. The results also confirmed that this relationship was stronger when an individual's job was characterized by unpredictability of the future. Our findings highlight the active role employees play for the experience of work as meaningful and suggests that encouraging proactive work behavior may be one avenue to promote work meaningfulness. [ABSTRACT FROM AUTHOR]

Introduction: To involve health service users in health care and health research priority setting, different methods exist. Which method is most suitable under which circumstances is unknown. We compared a postal Delphi survey and an in‐person workshop to involve health service users in priority settings for rehabilitative care and research in Germany. Methods: One hundred and eighty‐four former rehabilitants were randomly assigned to a postal Delphi survey (n = 152) or an in‐person workshop (n = 32). Two hundred and seventy‐six employees in rehabilitation were also invited to the Delphi Survey. The methodological comparison refers only to the sample of rehabilitants. Within each method, the participants agreed on the top 10 priorities for practice improvement and research in rehabilitative care. The priorities were compared descriptively. Participants' satisfaction was measured with the Public and Patient Engagement Evaluation Tool. The usability of both methods was compared based on the effort, time and material costs required for implementation. Results: Seventy‐five former rehabilitants and 41 employees in rehabilitation completed both Delphi survey rounds. Eleven former rehabilitants participated in the in‐person workshop. Priorities for practice improvement showed a high degree of overlap between both methods whereas research priorities differed greatly. Participants of the in‐person workshop felt significantly better prepared, more listened to and more likely to feel that different views on the topics were discussed. Participants of the Delphi survey expressed difficulties in understanding all survey questions. The Delphi survey was more elaborate in preparation and implementation but caused lower material costs. Conclusion: The differences in research priorities between the two methods could be due to the different samples, differences in the individual interests of participants or differences in the prioritization process. In‐person workshops seem to be more appropriate for complex topics, where clarifications of questions and deeper discussions are needed. Delphi surveys seem to be more suitable for easily understandable topics, larger sample sizes and when fewer financial resources are available. Patient or Public Contribution: The different study phases were supported by employees in rehabilitation and former rehabilitants (e.g., developing study documents, and interpreting results). [ABSTRACT FROM AUTHOR]

Diversity perspectives are philosophies of or approaches to diversity held by organizations, groups, or executives. They are important for organizations because they can determine the success or failure of diversity in the workforce. However, little is known about the predictors of diversity perspectives among executives. Using fuzzy set qualitative comparative analysis, we analyzed 50 interviews with top executives in Germany to identify individual and organizational characteristics that predict executives' adoption of a diversity perspective, in particular of a value‐in‐diversity perspective. Specifically, we analyzed gender, age, education level, vocational background, and tenure (individual characteristics), as well as size, sector of organization, and competitive environment (organizational characteristics), as potential predictors. We found single characteristics did not predict adoption, but configurations of characteristics did. Drawing on the person‐situation‐interactionist perspective, we developed specific profiles of executives likely to foster a value‐in‐diversity perspective and identified characteristics of their work environments that support such an approach. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Focused cardiac ultrasound (FCU) is a helpful tool to rapidly identify right ventricular (RV) causes of hemodynamic instability and facilitate the initiation of therapy. The clinical value of existing course models often remains unclear. This study investigated the effects of a one‐day FCU training on the visual estimation skills of RV characteristics. Methods: Four residents were included as the study group after completing a standardized one‐day FCU training. Four gender‐matched controls did not take part in the training. All residents graded image quality, RV systolic function, and RV dimensions in a test comprising 35 ultrasound clips. Results: The study and control group did not differ in ICU or ultrasound experience. Overall, training participants were able to distinguish between good and insufficient image quality significantly better than the control group (agreement 80.0% vs 61.4%, p = 0.04). The agreement for the estimation of RV function and RV dimensions was not different between the groups (63.2% vs 60.5%, p = 0.66 and 64.3% vs 67.1%, p = 0.18, respectively). Descriptively, only small differences were found between the groups for the estimation of RV function and RV dimensions in subgroups of patients with normal versus reduced systolic RV function or normal versus enlarged RV dimensions, respectively. Both groups struggled in identifying RV enlargement (34.6% vs 46.2%). Discussion: In this study, a single one‐day FCU training had no impact on residents' skills to visually assess systolic RV function or RV dimensions. Improvements of current training modalities or continuous teaching models are needed to optimize residency programs and patient care. [ABSTRACT FROM AUTHOR]

Background: Peer support is increasingly recognized as crucial for improving health and psychosocial outcomes in oncological care. The integration of cancer self‐help groups (SHGs) into cancer care facilities has gained importance in recent years. Yet, there is a lack of knowledge of the extent and quality of cooperation between cancer care facilities and SHGs and their integration into routine care. The concept of self‐help friendliness (SHF) provides a feasible instrument for the measurement of cooperation and integration. Methods: A cross‐sectional study across Germany investigates the experiences of 266 leaders of cancer SHGs concerning their cooperation with cancer care facilities based on the criteria for SHF. The participatory study was developed and conducted with representatives of the House of Cancer Self‐Help and the federal associations of cancer self‐help. Results: According to the SHG leaders, about 80% of their members primarily find their way to an SHG via other patients and only less than 50% more or less frequently via hospitals or rehabilitation clinics. The quality of cooperation with cancer centres, hospitals and rehabilitation clinics, however, is rated as good to very good by more than 70% of the respondents. Nine out of 10 quality criteria for SHF are fully or at least partially implemented, the values vary between 53% and 87%. Overall, 58% of the SHG leaders feel well to be very well integrated into care facilities. Conclusions: The results show a positive assessment of the involvement of SHGs in oncological care, but differences between inpatient and outpatient care and low referrals to SHGs are prominent. The concept of SHF is a feasible solution for a systematic and measurable involvement of SHGs. Patient or Public Contribution: The perspectives and insight of patient representatives obtained through qualitative interviews were directly incorporated into this study. Representatives of cancer self‐help organizations were involved in the development of the questionnaire, reviewed it for content and comprehensibility, and further helped to recruit participants. [ABSTRACT FROM AUTHOR]

Introduction: This mixed‐method study explores psychological needs, access and barriers in coronary heart disease (CHD) patients with and without mental health issues (MHI) within the German healthcare system. Methods: This study was conducted in three different healthcare settings: two hospitals, two rehabilitation clinics and three cardiology practices in Cologne, Germany. Patients were screened for angiographically documented CHD and other inclusion criteria. In total, 364 CHD patients took part in this study. It consisted of two parts: In the first part, participants filled in a newly developed questionnaire about their psychological needs, access and barriers within the healthcare system and their contact with their doctor in these matters. Then, patients were screened for MHIs with the help of the Hospital Anxiety and Depression Scale (HADS). When a score above seven was scored on the HADS, patients were additionally screened for specific MHIs using the Structured Clinical Interview for DSM‐IV Axis I Disorders. In the second part, 20 participants were subsequently interviewed in a semi‐structured interview to generate more in‐depth findings. Results: The interviews show that CHD patients with and without MHI experienced a cardiac event as life‐changing and had an urgent need to talk about CHD with their doctor, mostly the general practitioner (GP). When the GP spoke to the patient shortly after the cardiac event, patients experienced relief and were better able to cope with their illness. Only 9.1% reported being aided in their search for psychotherapeutic treatment or drug treatment (4.1%). Conclusion: The needs of CHD patients with and without MHI were not adequately satisfied within our sample. Psychological measures are necessary for sufficient improvement, such as training of doctors in doctor–patient communication (e.g., better support in coping with MHI/CHD), improvements in the procedure (more time for conversations during doctor contacts), and improvement of structural requirements (referring patients faster to psychotherapists). Patient or Public Contribution: We received input from patients during pretests and used the feedback to tailor our questionnaire and the interview guidelines. Afterwards, we disseminated the main results for the patient and public involvement (e.g., public lectures, leaflets for self‐help groups, etc.). [ABSTRACT FROM AUTHOR]