Search

The article presents abstracts of papers to be presented at the 33rd annual meeting of the Society for Psychophysiological Research. The meeting will be held in Rottach-Egem, Germany. The meeting will be from October 27-31, 1993. The majority of the research reports will be given and discussed informally at three poster sessions. The panel discussion will be on sensory memory and mismatch negativity. The mismatch negativity obtained with event-related potentials and magnetoencephalographic recordings, is dependent on a transient, acoustic memory that has been hypothesized to be what cognitive psychologists call sensory memory.

Background: Previous research has shown that teachers hold misconceptions about multimedia learning (e.g., multimedia instruction needs to be adapted to students' learning styles), which may be at odds with evidence‐based teaching. Objectives: Refutation texts are a classical method to reduce misconceptions and thus to stimulate conceptual change. We wanted to know whether making use of a computer algorithm to personalize refutation texts would best initiate teachers' conceptual change. Methods: We designed an online experiment, in which N = 129 in‐service teachers read either (1) expository texts (without direct refutation), (2) common refutation texts, or (3) personalized refutation texts. The teachers filled in a misconception questionnaire pre and post to assess their conceptual change. Results and Conclusions: Statistical analyses revealed that personalized refutation texts initiated the strongest conceptual change, which was driven by increased feelings of guilt and shame. Common refutation texts did not foster teachers' conceptual change as compared to expository texts. These findings indicate that refutation texts should be personalized for experienced practitioners such as teachers. Takeaways: Personalized refutation seems to be promising in the context of online teacher training programs. Further research should test to which extent the present findings also apply to other groups of experienced learners or practitioners. Lay Description: What is already known about this topic?: Teachers hold misconceptions about multimedia learning (e.g., learning materials should be adapted to students' individual learning styles, such as visualizers or verbalizers).Refutation texts, naming a commonly held misconception, disproving it and introducing a scientific explanation, are a common means to reduce misconceptions.Personalization fosters learning by drawing the learner's attention toward the discrepancy between their own beliefs and the learning material, further creating an impasse experience.Said impasse experience may trigger teachers' conceptual change, as, for teachers' conceptual change, a certain degree of discomfort is required. Yet, anger, caused by lessoning teachers on their topic may cause repulse and hamper learning. What this paper adds?: With a computer algorithm, we can efficiently personalize refutation texts by automatically matching them to teachers' answers in a pre‐test. Such a personalized refutation instruction may especially foster conceptual change.Within a randomized experiment, the personalized refutation instruction worked best compared to common refutation texts and expository texts.Feelings of guilt and shame moderated the effect of a personalized refutation, as teachers felt more addressed in their misconceptions and thus experienced the required impasse experience.Feelings of anger did not play an important role within our experiment. The implications of study findings for practitioners: Computer algorithms enable efficient personalization of instruction to better deal with heterogeneous groups of learners (e.g., with big differences in prior knowledge or experience, such as in the case of in‐service teachers).Refutation texts work better for teachers when they are personalized. Common refutation texts do not work better than expository texts.An advantage of digital instruction is the use of algorithms to efficiently personalize instructions even for larger groups. [ABSTRACT FROM AUTHOR]

This paper aims at explaining whether R&D subsidies, the engagement in collaboration networks and the location influence the patent activities of biotech firms in Germany! We demonstrate that R&D subsidies focusing on single firms do not increase patent intensity, while subsidies which are granted to joint R&D projects do so to a certain extent. The number of knowledge links firms have is not influencing performance, but the type of network partners has an effect. We found strong evidence that some but not too much cognitive distance between collaboration partners and being located in a cluster have a positive effect. [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]

Background: Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. Methods: This manuscript presents and discusses the methodological framework of the ImpPeer‐Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed‐methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. Discussion and Practical Implications: The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. Patient and Public Contribution: The research team of the ImpPeer‐Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation. [ABSTRACT FROM AUTHOR]

Medical students in Germany have to write a research thesis to acquire the title of medical doctor. This study evaluates the contribution of student research to the Medline™-indexed publications of a German medical faculty. A 1993–1995 Medline™-publication list, on which medical students among authors should be marked, was sent to medical faculty staff of the University of Würzburg, Germany (n = 238). Faculty members responded (106, 45%), 66 were working at a clinic, 26 at a clinic-associated institute and 14 at a basic science institute. Between 1993 and 1995, 1128 Medline™-indexed papers were published by these faculty members, who on average supervised 4·5 medical students (n = 477). Medical students were among the authors of 316 (28%) and were the first authors of 88 papers (7·8%). For 66% of medical students their research resulted in a Medline™-indexed publication. Medical student research activity can significantly influence the published output of a medical faculty. [ABSTRACT FROM AUTHOR]

Aim This paper explores the experiences of older German Australians, with a focus on their support needs and preferences in later life. Methods Data were collected through qualitative semi-structured interviews. Data analysis incorporated a systematic concept matrix approach to content analysis. Results The findings of the study indicate that older German Australians have adapted well to the Australian way of life. Their high English language proficiency allowed them to source services without the barrier of language often reported in studies of older migrants. They did not show high interest in ethno-specific services. Conclusion Few studies have been conducted on older German Australians, and none focuses specifically on their experience of ageing in Australia. This study contributes to the body of knowledge on older migrants and, specifically, on those for whom language is not necessarily a major obstacle to obtaining aged care information or services. [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]

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]

This paper examines the logic and morality of the German Stem Cell Act of 2002. After a brief description of the law's scope and intent, its ethical dimensions are analysed in terms of symbolic threats, indirect consequences, and the encouragement of immorality. The conclusions are twofold. For those who want to accept the law, the arguments for its rationality and morality can be sound. For others, the emphasis on the uniqueness of the German experience, the combination of absolute and qualified value judgments, and the lingering questions of indirect encouragement of immoral activities will probably be too much.

Presents information on the plenaries, workshops, and research papers contributed by several experts in the field of ethology presented at the 5th International Symposium on Physiology, Behavior and Conservation of Wildlife in Berlin, Germany.

Although the leadership literature has emphasized the importance of leader identity for leader behaviors and leader effectiveness, little is known about whether and how professionals, who are experts in their field and hold a formal leader role, construe a leader identity. To expand our understanding of leader identity construal, we explored how professors in German research universities interpreted their formal leader role and whether and how they saw themselves as leaders. Based on findings from an inductive interview study, we contribute to the literature in three ways: First, our findings imply that patterns of professional identity and leader identity dimensions likely predict when a leader role is rejected, accommodated, incorporated, or emphasized. Second, we explain why professionals with a formal leader role see themselves primarily as specialists, mentors, managers, or shapers. Third, we extend previous notions of the leader identity concept by elaborating on its dimensions. Our findings have practical implications on an individual and organizational level, and may help design more effective leadership development programs. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to test the psychometric properties of the Facilitative Student–Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries. Design: A multi‐country, cross‐sectional survey design was applied. Methods: A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha. Results: Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two‐factor construct explaining 47.7% of the total variance, identifying two sub‐scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two‐factor structure. The Cronbach alpha coefficients (0.8–0.9) indicated acceptable reliability of the scale. [ABSTRACT FROM AUTHOR]

Today's business environment is becoming increasingly dynamic, and the concept of agility is gaining attention in the corporate world and in academia. The objective of our research is to explain how talent management (TM) can shape talents as key human resources, according to company‐specific agility needs, and thus contribute to gaining competitive advantage in dynamic firm environments. We approach this task by viewing it from the perspective of dynamic capabilities. A total of 24 semistructured interviews were conducted with senior TM professionals working in German companies differing in terms of size, age, structure, industry, and ownership. As a result, we identified three different types of dynamic TM capabilities promoting organizational agility to various extents. By rooting our qualitative study in the research fields of TM and agility in the under‐researched theoretical realm of dynamic capabilities, we contribute to the theoretical as well as the empirical discussion by addressing the specific challenges of an increasingly dynamic environment. As a result, we provide a contextualized viewpoint from which to explain the process inherent in dynamic TM capabilities that continuously shape talent and organizational agility. [ABSTRACT FROM AUTHOR]

Background: Interprofessional teams and peer support are being increasingly considered in informed shared decision‐making. In Germany, there appear to be deficits in the implementation of informed shared decision‐making in the choice of renal replacement therapy, such as the lack of collaboration in interprofessional teams and the absence of structured peer support programmes for patients with chronic kidney disease. Objective: To explore nephrologists' and nurses' perspectives regarding their involvement in shared decision‐making when choosing renal replacement therapy. Design: Guideline‐based, problem‐centred interviews were used. Participants: A total of 20 nephrologists and 15 nurses were recruited from 21 dialysis units all over Germany. Approach: Interviews were audio‐recorded and transcribed. They were analysed thematically using structuring and summary content analysis, supported by the qualitative data analysis software MAXQDA 12. Results: The most important findings were the late or missing participation of nurses in the informed shared decision‐making process and the unstructured peer support. Along with time and financial factors, these aspects were seen as barriers to shared decision‐making with patients who are often overwhelmed by the diagnosis. Furthermore, informed shared decision‐making has been insufficiently considered in professional education and training. Conclusion: Shared decision‐making in the choice of renal replacement therapy is particularly challenging due to the patients' high disease burden. The greater incorporation of informed shared decision‐making in education and training as well as the consistent involvement of nursing staff and structured peer counselling already in the predialysis phase with adequate reimbursement can address the identified hurdles. [ABSTRACT FROM AUTHOR]

Objectives: Seroprevalence studies of SARS‐CoV‐2 have shown that there is a high number of undiagnosed missing cases. Seroprevalence of SARS‐CoV‐2 in people living with HIV (PLWH) is lacking. Therefore, we conducted a prospective cross‐sectional study to estimate the seroprevalence of SARS‐CoV‐2 among PLWH without known diagnosis of COVID‐19 in the south‐west of Germany. Methods: Serological testing for SARS‐CoV‐2 immunoglobulin G (IgG) antibodies based on two assays was performed in PLWH who visited the outpatient HIV centre of two hospitals from April to June 2020. Additionally, patients had to answer questionnaires about possible COVID‐19‐related symptoms and predefined risk factors. Moreover, we tested 50 non‐HIV‐infected patients receiving post‐ or pre‐exposure (PEP/PrEP) HIV prophylaxis. Results: In all, 594 (488 male, 106 female) PLWH (median age 51 years) and 50 PEP/PrEP‐users were included in the study. The estimated seroprevalence of the PLWH cohort was 1.85% (11/594), with 11 positive tested cases in the cohort. Among all patients, only five had COVID‐19‐related symptoms. One PCR‐positive patient did not show any antibody response in repeatedly carried out tests. None of the patients was hospitalized due to COVID‐19. Three PrEP users were tested positive. Three patients had been previously diagnosed with SARS‐COV‐2 infection before inclusion. The used questionnaire did not help to detect SARS‐CoV‐2 positive patients. Conclusions: Despite the limitation of being only a snapshot in time because of the ongoing pandemic, to our knowledge this is the largest study so far on seroprevalence of SARS‐CoV‐2 in PLWH in Germany. Our study suggests that the seroprevalence of SARS‐CoV‐2 in PLWH is comparable to those previously reported for parts of the general German population and that the questionnaire used here might not be the best tool to predict COVID‐19 diagnosis. [ABSTRACT FROM AUTHOR]

Background: Medical rehabilitation plays an important role in the health care of chronically ill children and adolescents. During medical rehabilitation, supporting illness‐related self‐regulation is a central goal. Beliefs about illness and beliefs about treatment are core elements of patients' self‐regulation, and there is evidence that these beliefs are relevant predictors of different health‐ and treatment‐related outcomes such as adherence. However, little is known about adolescents' beliefs about rehabilitation. This study therefore explores adolescents' treatment beliefs in the context of inpatient medical rehabilitation. Methods: A qualitative study was conducted in a German rehabilitation clinic for children and adolescents. Using a purposive sampling method, 13 adolescents (12–16 years old) were recruited. Semi‐structured, audiotaped interviews were conducted and analysed using content analysis. Results: Results demonstrate that adolescents have differentiated rehabilitation‐related treatment beliefs. Twelve themes, with various subthemes, emerged, which include access to and knowledge about rehabilitation, the rehabilitation‐related individual position and normative aspects, expectations of oneself, as well as in respect of the social context (fellow patients, contact with family and friends), expectations of the structure, process and outcome of rehabilitation, concerns and barriers and emotional aspects. Conclusions: Our explorative study revealed a broad range of rehabilitation‐related treatment beliefs in adolescents, indicating parallels, but also differences, to research results with adults. Treatment beliefs are assumed to be an influencing factor for various health‐ and treatment‐related outcomes. Thus, implications of our findings for clinical practice and further research are discussed. [ABSTRACT FROM AUTHOR]

Aim: To measure safety performance, situational judgement test, which is a method composed of job‐related situations, can be used. This study aimed to develop and test its psychometric properties by measuring the safety performance of healthcare professionals in German hospitals. Design: An explorative cross‐sectional study. Methods: A team of researchers, nurses and physicians developed seven items, which focus on different safety areas. Descriptive statistics were calculated for each item. Cronbach's alpha was calculated as an indication of internal consistency. Spearman's correlation between the items was evaluated as analysis of construct validity. A cross‐sectional survey with healthcare professionals in three German hospitals was conducted to test the developed instrument. Results: A total of 168 healthcare professionals participated (response rate: 39.1%). 70.2% were women, and 38.7%, 33.9%, 15.5% and 11.3% were registered nurses, nurses in training, physicians and other healthcare professionals respectively. The situational judgement test demonstrated an acceptable psychometric performance. [ABSTRACT FROM AUTHOR]

Examining selected poems from Mariella Mehr's volumes Nachrichten aus dem Exil (1998) and Widerwelten (2001), this article explores the ways that the Swiss writer Mehr refigures the notion of Heimat and its relationship to language. Tracing three key sources that supply the vocabulary and concepts within Mehr's lyrical treatment of Heimat—her own life experiences of persecution and rootlessness in postwar Switzerland, received notions of Heimat from Germanic culture, as well as the minority Yenish culture from which Mehr was forcibly estranged—this paper argues that Mehr turns to poetry to decouple Heimat from a geographically fixed, exclusionary concept, expanding it to capture complex intercultural experiences. Moreover, I attempt to unravel the paradox latent in Mehr's work, wherein the poetic subject's predominantly unsatisfied struggle for home must be reconciled with Mehr's own assertion of language's decisive role in achieving Heimat. [ABSTRACT FROM AUTHOR]

A research workshop at Mannheim University, Germany, brought together a small group of Europe-based experts in system dynamics to discuss basic assumptions about rationality in system dynamics modeling and simulation. As an underlying theme it was found that—although system dynamics is open for various notions of rationality—policies are mostly modeled to be bounded rational and, in this sense, system dynamics models are valid descriptions of real-world situations. By reviewing key points emerging during the debates against the relevant literature, this article identifies a number of important further research issues. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To participate in shared decision making (SDM), patients need to understand their options and develop trust in their own decision‐making abilities. Two experiments investigated the potential of decision aids (DAs) in preparing patients for SDM by raising awareness of preference‐sensitivity (Study 1) and showing possible personal motives for decision making (Study 2) in addition to providing information about the treatment options. Methods: Participants (Study 1: N = 117; Study 2: N = 217) were put into two scenarios (Study 1: cruciate ligament rupture; Study 2: contraception), watched a consultation video and were randomized into one of three groups where they received additional information in the form of (a) narrative patient testimonials; (b) non‐narrative decision strategies; and (c) an unrelated text (control group). Results: Participants who viewed the patient testimonials or decision strategies felt better prepared for a decision (Study 1: P <.001, ηP2 = 0.43; Study 2: P <.001, ηP2 = 0.57) and evaluated the decision‐making process more positively (Study 2: P <.001, ηP2 = 0.13) than participants in the control condition. Decision certainty (Study 1: P <.001, ηP2 = 0.05) and satisfaction (Study 1: P <.001, ηP2 = 0.11; Study 2: P =.003, d = 0.29) were higher across all conditions after watching the consultation video, and certainty and satisfaction were lower in the control condition (Study 2: P <.001, ηP2 = 0.05). Discussion: Decision aids that explain preference‐sensitivity and personal motives can be beneficial for improving people's feelings of being prepared and their perception of the decision‐making process. To reach decision certainty and satisfaction, being well informed of one's options is particularly relevant. We discuss the implications of our findings for future research and the design of DAs. [ABSTRACT FROM AUTHOR]

This study aims to shed light on the implementation of HR practices as a key piece of the human resource management ( HRM)-performance puzzle. Although the literature suggests that discrepancies between the organization's intended and implemented HR practices are essential to understanding employees' perceptions of and reactions to HRM, little attention has been devoted to this issue. Drawing upon a multiple-case study of German health and social services organizations, we therefore explore the linkages (and potential gaps) between intended, implemented, and perceived HR practices. Our study provides new insights into the underlying mechanisms of this relationship, highlighting an organization's ability to leverage its resources as playing a crucial moderating role in implementing intended HR practices, while employees' expectations of HRM moderate the link between implemented and perceived HR practices. We advance a set of propositions that contributes to a more nuanced, multilevel understanding of the complex phenomenon of HRM implementation. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: The unmonitored use of complementary medicine in patients with cancer can be associated with an increased risk of safety-related issues, such as lower adherence to conventional cancer therapies. Training oncology physicians to advise their patients about the effectiveness and safety of these therapies could improve this situation.Methods: The objective of this study was to develop and pretest a consultation framework that has high potential to be widely implemented. The framework comprises: 1) a systematically developed and tested, manualized, guided consultation; and 2) blended learning training (e-learning and communication skills training workshop) to upskill oncology physicians in advising their patients on complementary and integrative medicine (CIM). For this implementation study, mixed methods were used to develop the manual (literature review, consensus procedure, pilot testing) and the training (questionnaires and interviews with oncology physicians and patients with cancer and an examination of the skills in a setting with standardized patients).Results: The training was tested with 47 oncology physicians from across Germany. The manual-guided consultation (context: general information on the setting and communication techniques; inform: consultation duration and content; capture: previous CIM use; prioritize: focus on consultation; advise: evidence-based CIM recommendations; discuss, advise, accept, or advise against other CIM; concretize advice: summary and implementation; and monitor: documentation) was considered suitable. The structure and time frame (maximum, 20 minutes) of the consultation as well as the training were feasible and well accepted.Conclusions: The current study demonstrates that the KOKON-KTO framework (a German acronym for Competence Network for Complementary Medicine - Consultation Training for Oncology Physicians) is suitable for training oncology physicians. Its implementation can lead to better physician-patient communication about CIM in cancer. [ABSTRACT FROM AUTHOR]

Research activities related to social informatics (SI) are expanding, even as community fragmentation, topical dispersion, and methodological diversity continue to increase. Specifically, the different understandings of SI in regional communities have strong impacts, and each has a different history, methodological grounding, and often a different thematic focus. The aim of this article is to connect three selected perspectives on SI—intellectual (regional schools of thought), methodological, and thematic—and introduce a comparative framework for understanding SI that includes all known approaches. Thus, the article draws from a thematic and methodological grounding of research across schools of thought, along with definitions that rely on the extension and intension of the notion of SI. The article is built on a paralogy of views and pluralism typical of postmodern science. Because SI is forced to continually reform its research focus, due to the rapid development of information and communication technology, social changes and ideologies that surround computerization and informatization, the presented perspective maintains a high degree of flexibility, without the need to constantly redefine the boundaries, as is typical in modern science. This approach may support further developments in promoting and understanding SI worldwide. [ABSTRACT FROM AUTHOR]

Objective: To examine the effectiveness of single and repeat sonographic cervical-length (CL) measurement in predicting preterm delivery in symptomatic women with a twin pregnancy.Methods: This was a retrospective study of women with a twin gestation who presented with painful and regular uterine contractions at 24 + 0 to 33 + 6 weeks' gestation at the perinatal unit of the University Hospital of Tübingen, Tübingen, Germany between 2012 and 2018. CL was measured on transvaginal ultrasound at the time of admission and a few days later after cessation of contractions. Treatment included administration of tocolytics (usually oral nifedipine), for no more than 48 h, and administration of steroids if CL was ≤ 25 mm. Patients were clustered into five groups according to the CL measurement obtained at first assessment: < 10.0 mm; between 10.0 and 14.9 mm; between 15.0 and 19.9 mm; between 20.0 and 24.9 mm; and ≥ 25.0 mm. For each group, we calculated the test performance of CL measurement for prediction of preterm delivery within the subsequent 7 days and before 34 weeks' gestation. Regression analysis was used to evaluate the test performance of the second CL measurement for predicting preterm delivery within 7 days after the second assessment.Results: The study population consisted of 257 twin pregnancies, of which 80.2% were dichorionic diamniotic. Median maternal and gestational ages at the time of admission were 32.0 years and 29.9 weeks' gestation, respectively. Preterm birth within 7 days of admission occurred in 23 (8.9%) pregnancies, and 82 (31.9%) patients delivered prior to 34 weeks' gestation. Median CL for the entire study population was 17.0 mm. Delivery within 7 days after the first assessment occurred in 29.0%, 10.6%, 4.2%, 6.3% and 0% of women with CL < 10.0 mm, 10.0-14.9 mm, 15.0-19.9 mm, 20.0-24.9 mm and ≥ 25.0 mm, respectively. There was a weak, but significant, association between the CL measurement at the time of admission and the time interval between admission and delivery (interval = 27.9 + 0.58 × CL; P = 0.003, r = 0.184). CL was measured again after a median time interval of 3 (interquartile range (IQR), 2-5) days in 248 cases. Median second CL measurement was 17.0 (IQR, 11.5-22.0) mm. Delivery occurred within the subsequent 7 days after the second measurement in 25/248 (10.1%) cases. Binary regression analysis indicated that the first (odds ratio (OR), 0.895; P = 0.003) and second (OR, 0.908; P = 0.002) CL measurements, but not the difference between the two measurements (OR, 0.961; P = 0.361), were associated significantly with delivery within 7 days after the second measurement. Receiver-operating-characteristics (ROC)-curve analysis for the prediction of delivery within 7 days after the second assessment did not show a significant difference between the predictive performance of the first (area under ROC curve (AUC), 0.676 (95% CI, 0.559-0.793)) and the second (AUC, 0.661 (95% CI, 0.531-0.790)) measurement.Conclusion: Sonographic measurement of CL can be helpful in predicting preterm delivery within 7 days of presentation in symptomatic women with a twin gestation; however, the test performance is relatively weak. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Summary: Background: Non‐alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes mellitus are known to be closely linked with obesity as early as during childhood. Objectives: The study aimed to determine the prevalence of prediabetes and T2DM in children with obesity with or without increased transaminases. Methods: Data from the observational multicentre (n = 51), cross‐sectional Adipositas Patienten Verlaufsbeobachtung registry were analyzed. Mild increase (mild group) was defined by alanine transaminase (ALT) >24 to ≤50 U/L and moderate to severe increase (advanced group) by ALT > 50 U/L. Prediabetes and T2DM were defined according to recent IDF/ISPAD guidelines. Results: The prevalence of prediabetes and T2DM was 11.9% (95% CI: 11.0–12.8) and 1.4% (95% CI: 1.1–1.7) among all participants (n = 4932; male = 2481; mean age 12.9 ± 2.7 years; BMI‐SDS 2.1 ± 0.5; Tanner stage 3.2 ± 1.5). The prevalence of impaired glucose metabolism (prediabetes and T2DM) was 13.8% (95% CI: 12.1–15.4) in the mild, 21.9% (95% CI: 18.8–25.1) in the advanced group, 10.7% (95% CI: 9.4–11.9) in the control group. Mild and advanced groups had greater odds ratios for prediabetes [1.42; 95% CI: 1.17–1.72, 2.26‐fold; (1.78–2.86), respectively], the advanced group also for T2DM [2.39 (1.36–4.21)] compared to controls. While an increase in transaminases predominantly affected boys, girls within the advanced group had a higher T2DM prevalence than males (5.4 vs. male 2.1%). Conclusions: Children with obesity and increased liver transaminases as surrogates of NAFLD should be screened for T2DM. [ABSTRACT FROM AUTHOR]

Viewing knowledge as rooted in individuals, this study investigates knowledge transfer in multinational corporations (MNCs) from an individual-level perspective. Specifically, the author focuses on inpatriates as a particular group of knowledge actors in MNCs and examines the role of inpatriates' boundary spanning between their home unit and the headquarters for transferring their knowledge to headquarters staff. Based on a sample of 269 inpatriates in 10 German MNCs, the author found that inpatriates' boundary spanning is positively related to inpatriates' individual efforts to transfer knowledge and inpatriates' perceptions of HQ staff efforts to acquire subsidiary-specific knowledge. Both perceived HQ absorptive capacity and mentoring by HQ staff moderate these relationships. This study's findings contribute to our understanding of the theoretical mechanisms through which MNC knowledge flows occur and highlight key requirements for the design of international staffing practices. ©2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Formal and relational governance mechanisms are used in strategic alliances to coordinate resources and mitigate the risk of opportunistic behavior. While recent work has shown that these approaches are not mutually exclusive, we understand little about when one approach is superior to the other. Using data on the governance choices and subsequent performance of alliances in the German telecommunications industry, we find that the optimal configuration of formal and relational governance mechanisms depends on the assets involved in an alliance, with formal mechanisms best suited to property-based assets and relational governance best suited to knowledge-based assets. Furthermore, a mismatch between governance mechanisms and asset type can harm the performance of the alliance. Our findings contribute to transaction cost economics, the literature on relational governance, and recent work studying their interaction. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Mental health professionals (MHPs) are in a central position to provide support for mental health service users (MHSUs) in regard to parental needs, from preconception to caring for children. This study aims to examine whether mental health nurses and psychiatrists regard the issue of having children and being a parent as relevant to be considered in a clinical setting, how they describe the MHPs' roles and responsibilities in this regard, and to what extent they feel willing and able to fulfil these demands. A qualitative approach was undertaken by conducting four focus groups with 30 MHPs (15 nurses and 15 psychiatrists) within an inpatient mental health service in south Germany. We found that MHPs generally acknowledged the importance of parenting issues for psychiatric treatment. However, they assessed the talks between MHPs and MHSUs about parenting as less relevant in routine practice; the issue of the desire for children in particular was seen as generally not important. Addressing parenthood issues was restricted to mainly two areas: clarifying children's situations during inpatient treatment and considering medication issues among (potentially) pregnant service users. MHPs' focus on the adult service user, privacy, and historical issues were the main arguments against addressing parenthood issues. [ABSTRACT FROM AUTHOR]

Objectives: To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons.Data Sources/study Setting: County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used.Study Design: A retrospective cross-sectional study using in- and outpatient secondary data was performed.Data Collection: Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care.Principal Findings: Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment.Conclusions: Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. [ABSTRACT FROM AUTHOR]

Objective: Little attention has been given to psychological factors as correlates of health care use, which could be an important key to manage it. We analyzed the association of psychological factors with health care use.Data Sources: Primary data were obtained from three follow-ups (2002, 2008, and 2011) of a large population-based study with participants aged 40+.Study Design: Using a longitudinal observational study, we analyzed the psychological factors of negative and positive affect (affective well-being), life satisfaction (cognitive well-being), self-efficacy, loneliness, self-esteem, optimism, and flexible goal adjustment using fixed-effects regressions.Data Collection: The participants provided data on health care use (visits to general practitioners [GPs] and specialists as well as hospitalization) and psychological factors via self-administered questionnaires and personal interviews (7,116 observations). The sample was drawn using national probability sampling.Principal Findings: Controlling for self-rated health, chronic diseases and sociodemographics, increases in affective well-being, and optimism decreased health care use of GPs, specialists, and hospital treatment. Increases in cognitive well-being decreased health care use of GPs and specialists. Increases in self-efficacy decreased hospitalization.Conclusions: The study underlines the influence of psychological factors on health care use. Thus, whenever possible, future studies of health care use should include psychological factors, and efforts to reduce health care use might focus on such factors. [ABSTRACT FROM AUTHOR]

Objective: To assess whether a combination of Internet-based and postal survey methods (mixed-mode) compared to postal-only survey methods (postal-only) leads to improved response rates in a physician survey, and to compare the cost implications of the different recruitment strategies.Data Sources/study Setting: All primary care gynecologists in Bremen and Lower Saxony, Germany, were invited to participate in a cross-sectional survey from January to July 2014.Study Design: The sample was divided into two strata (A; B) depending on availability of an email address. Within each stratum, potential participants were randomly assigned to mixed-mode or postal-only group.Principal Findings: In Stratum A, the mixed-mode group had a lower response rate compared to the postal-only group (12.5 vs. 20.2 percent; RR = 0.61, 95 percent CI: 0.44-0.87). In stratum B, no significant differences were found (15.6 vs. 16.2 percent; RR = 0.95, 95 percent CI: 0.62-1.44). Total costs (in €) per valid questionnaire returned (Stratum A: 399.72 vs. 248.85; Stratum B: 496.37 vs. 455.15) and per percentage point of response (Stratum A: 1,379.02 vs. 861.02; Stratum B 1,116.82 vs. 1,024.09) were higher, whereas variable costs were lower in mixed-mode compared to the respective postal-only groups (Stratum A cost ratio: 0.47, Stratum B cost ratio: 0.71).Conclusions: In this study, primary care gynecologists were more likely to participate by traditional postal-only than by mixed-mode survey methods that first offered an Internet option. However, the lower response rate for the mixed-mode method may be partly due to the older age structure of the responding gynecologists. Variable costs per returned questionnaire were substantially lower in mixed-mode groups and indicate the potential for cost savings if the sample population is sufficiently large. [ABSTRACT FROM AUTHOR]

Objective: Evaluating the potential of the high-dimensional propensity score (HDPS) to control for residual confounding in studies analyzing quality of care based on administrative health insurance data.Data Source: Secondary data from 2004 to 2009 from three German statutory health insurance providers.Study Design: We conducted a retrospective cohort study in patients with elective percutaneous coronary interventions (PCIs) and compared the mortality risk between the in- and outpatient setting using Cox regression. Adjustment for predefined confounders was performed using conventional propensity score (PS) techniques. Further, an HDPS was calculated based on predefined and empirically selected confounders from the database.Principal Findings: Conventional PS methods showed a decreased mortality risk for outpatient compared to inpatient PCIs, while trimming of patients with nonoverlap in the HDPS distribution and weighting resulted in a comparable risk. Most comorbidities were less prevalent in the HDPS-trimmed population compared to the original one.Conclusion: The HDPS methodology may reduce residual confounding by rendering the studied cohort more comparable through restriction. However, results cannot be generalized for the entire study population. To provide unbiased results, full assessment of all unmeasured confounders from proxy information in the database would be necessary. [ABSTRACT FROM AUTHOR]

Health is well known to show a clear gradient by occupation. Although it may appear evident that occupation can affect health, there are multiple possible sources of selection that can generate a strong association, other than simply a causal effect of occupation on health. We link job characteristics to German panel data spanning 29 years to characterize occupations by their physical and psychosocial burden. Employing a dynamic model to control for factors that simultaneously affect health and selection into occupation, we find that selection into occupation accounts for at least 60% of the association. The effects of occupational characteristics such as physical strain and low job control are negative and increase with age: late-career exposure to 1 year of high physical strain and low job control is comparable to the average health decline from ageing 16 and 6 months, respectively. [ABSTRACT FROM AUTHOR]

Two studies showed an improvement in clinical outcomes after alcohol approach bias retraining, a form of Cognitive Bias Modification (CBM). We investigated whether transcranial direct current stimulation (tDCS) could enhance effects of CBM. TDCS is a neuromodulation technique that can increase neuroplasticity and has previously been found to reduce craving. One hundred alcohol-dependent inpatients (91 used for analysis) were randomized into three experimental groups in a double-blind parallel design. The experimental group received four sessions of CBM while receiving 2 mA of anodal tDCS over the dorsolateral prefrontal cortex (DLPFC). There were two control groups: One received sham stimulation during training and one received active stimulation at a different moment. Treatment outcomes were abstinence duration (primary) and relapse after 3 and 12 months, craving and approach bias (secondary). Craving and approach bias scores decreased over time; there were no significant interactions with experimental condition. There was no effect on abstinence duration after three months (χ2(2) = 3.53, p = 0.77). However, a logistic regression on relapse rates after one year (standard outcome in the clinic, but not-preregistered) showed a trend when relevant predictors were included; relapse was lower in the condition receiving active stimulation during CBM only when comparing to sham stimulation (B = 1.52, S.E. = .836, p = .07, without predictors: p = .19). No strong evidence for a specific enhancement effect of tDCS on CBM was found. However, in a post-hoc analysis, tDCS combined with CBM showed a promising trend on treatment outcome. Important limitations are discussed, and replication is necessary to find more reliable effects. [ABSTRACT FROM AUTHOR]

Background: Telephone surveys are intended to reduce attrition in longitudinal studies. For paediatric chronic pain patients, the comparability of pain-related information gathered using telephone interviews and postal surveys remain unknown. Furthermore, it remains unknown how social desirability may influence answers.Methods: To compare data from telephone interviews and postal surveys, a randomized cross-over design with two measure points 2 weeks apart and four conditions (combinations of telephone interviews (T) and postal surveys (P): P-T, T-P, P-P, T-T) was conducted in a sample of N = 323 paediatric chronic pain patients.Results: In the inter-group comparison, pain-related information did not differ between telephone interviews and postal surveys except for the information on pain location (back and extremities). Agreement measures of the intra-group comparisons suggest substantial to excellent agreements for all items and did not differ between the groups. The internal consistency of a disability scale was excellent for both assessment modes; the number of missing values did not differ. Participation rate was higher for telephone interviews compared to the postal surveys. Across both time points, attrition was lowest for the groups without a switch in assessment mode compared to the groups with a switch in assessment mode. Except for pain-related school absence, no effect of social desirability occurred.Conclusions: Telephone interviews are a useful method to achieve a high response rate. Pain locations should be asked for separately and not in an open question when interviewing children and adolescents on the telephone.Significance: Telephone interviews are a good method to achieve a high response rate and obtain valid data in studies with paediatric chronic pain patients. [ABSTRACT FROM AUTHOR]

Aim: Poverty has often been associated with malnutrition, stunted growth, impaired cognitive development and poor earnings. We studied whether these associations were found in German men born and raised shortly after World War II during severe and long-standing nationwide malnutrition.Methods: We analysed German old-age pension payments, as a rough measure of lifetime earnings, in German men born from 1932 to 1960 and compared the at-risk-of-poverty rates of German men born in 1945-1948 versus 1935-1938 and 1955-1958.Results: Substantially fewer women worked during this period and their longer life expectancy makes their pension payments difficult to interpret. We therefore limited our analysis to men. Men born in the 1930s received the highest monthly old-age pensions and these declined slightly in men born from 1945 to 1948, indicating a minute impairment in work-related income in cohorts born shortly after the war. We also found that there was no evidence for increased at-risk-of-poverty rates in men born in 1945-1948 versus those born in 1935-1938 and in 1955-1958.Conclusion: Being born and raised following World War II was associated with a minute work and pension impairment that was not visible in the at-risk-of-poverty rates. These findings question statements associating early childhood nutrition and future lifetime earnings. [ABSTRACT FROM AUTHOR]

Objective: Although one-third of cancer patients are perceived to have a need for psychological support based on the percentage of mental disorders, little is known about the actual utilization of psychological care in cancer. We aimed to assess cancer patients' reported use of psychological care and its correlates in a large, representative sample.Methods: In a multicenter, cross-sectional study in Germany, 4020 cancer patients (mean age 58 years, 51% women) were evaluated. We obtained self-reports of use of psychotherapy and psychological counseling. We measured distress with the Distress Thermometer, symptoms of depression with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder Scale, and social support with the Illness-specific Social Support Scale. In a subsample of 2141, we evaluated the presence of a mental disorder using the Composite International Diagnostic Interview.Results: In total, 28.9% (95% confidence interval 27.4%-30.4%) reported having used psychotherapy or psychological counseling or both because of distress due to cancer. Independent correlates of utilization included age (odds ratio [OR] = 0.97 per year], sex (male, OR = 0.55), social support (OR = 0.96), symptoms of depression (OR = 1.04) and anxiety (OR = 1.08), the diagnosis of a mental disorder (OR = 1.68), and a positive attitude toward psychosocial support (OR = 1.27). Less than half of those currently diagnosed with a mental disorder reported having taken up psychological support offers.Conclusion: Special efforts should be made to reach populations that report low utilization of psychological care in spite of having a need for support. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effects a home-based exercise program delivered to ill and mobility-limited elderly individuals on physical function, physical activity, quality of life, fall-related self-efficacy, and exercise self-efficacy. Design Randomized controlled trial ( ISRCTN Registry, Reg.-No. ISRCTN17727272). Setting Fifteen general practitioner ( GP) practices and participants' homes. Participants Chronically ill and mobility-limited individuals aged 70 and older (N = 209). Interventions An exercise therapist delivered the experimental intervention-a 12-week multidimensional home-based exercise program integrating behavioral strategies-in individual counseling sessions at the GPs' practices and over the telephone. The control intervention focused on promoting light-intensity activities of daily living. Interventions took place between February 2012 and March 2013. Measurements The primary outcome was functional lower body strength (chair-rise test). Secondary outcomes were physical function (battery of motor tests), physical activity (step count), health-related quality of life (Medical Outcomes Study 8-item Short-Form Survey), fall-related (Falls Efficacy Scale-International Version), and exercise self-efficacy (Selbstwirksamkeit zur sportlichen Aktivitaet ( SSA) scale). Postintervention differences between the groups were tested using analysis of covariance (intention to treat; adjusted for baseline value and GP practice; significance level P ≤ .05). Results Participants had a mean age ± standard deviation of 80 ± 5, 74% were female, 87% had three or more chronic diseases, and 54% used a walking aid. The difference (intention to treat; experimental minus control) between adjusted postintervention chair-rise times was −0.1 (95% confidence interval = −1.8-1.7). Differences for all secondary outcomes were also nonsignificant. Conclusion The program was ineffective in the target population. Possibilities for improving the concept will have to be evaluated. [ABSTRACT FROM AUTHOR]

Objectives The objective of this study was to investigate the social validity of cognitive-behavioural parent training ( CBPT) delivered in two formats to parents who have children with hyperkinetic disorder ( HKD) with and without medication. Design Compared individual with group treatment as part of a multicentre randomized controlled trial. Method Obtained a broad range of evaluations and satisfaction ratings post-treatment and related them to pre-treatment and treatment factors. Results Attendance rates were high in the individual and slightly less in the group training. Levels of satisfaction were high in both treatment arms with large numbers rating the outcomes, the trainers and the overall training very favourably. Medication showed no effect on parental evaluations. Evaluation of outcomes and satisfaction with the trainer emerged as strong predictors of overall programme satisfaction. Conclusion The social validity of cognitive-behavioural parent training for hyperkinetic children was supported by high levels of treatment acceptability across a range of indicators and for children with and without medication. Practitioner points Both forms of treatment delivery lead to high rates of consumer satisfaction., Consumer evaluations of CBPT appear independent of medication for HKD., Course satisfaction is clearly associated with two factors that trainers can affect: The parent-trainer relationship and parents' sense of achievement., Limitations include the following Far more mothers than fathers attended the trainings., Attitudes may differ in other cultures. [ABSTRACT FROM AUTHOR]

Background: In German emergency medical services (EMS), the analgesia is restricted to physicians. In this prospective, interventional, multicentre trial, complications with and quality of telemedically delegated analgesia were evaluated.Methods: If prehospital analgesia was necessary, five telemedically equipped paramedic ambulances from four different districts could consult a telemedicine centre. Analgesics were delegated based on a predefined algorithm. Telemedically assisted cases were compared with local historical regular EMS missions using matched pairs. The primary outcome was the frequency of therapeutic complications (respiratory/circulatory insufficiency, allergic reactions). Secondary outcomes were quality of analgesia (11-point numerical rating scale, NRS) and the frequency of nausea/vomiting.Results: Analgesia was necessary in 106 telemedically assisted missions. In 23 cases, the telemedical procedure was used until an EMS physician arrived. Of the remaining 83 cases, 80 could be matched to comparable controls. Complications did not occur in either the study group or the control group (0 vs. 0; p = N/A). Complete NRS documentation was noted in 65/80 (study group) and 32/80 (control group) cases (p < 0.0001). Adequate initial pain reduction (quality indicator: reduction of NRS ≥ 2 points or NRS < 5 at end of mission) occurred in 61/65 versus 31/32 cases (p = 1.0); NRS reduction during mission was 3.78 ± 2.0 versus 4.38 ± 2.2 points (p = 0.0159). Nausea and vomiting occurred with equal frequency in both groups.Conclusions: Telemedical delegation of analgesics to paramedics was safe and led to a pain reduction superior to the published minimum standard in both groups. The documentation quality was better in the telemedicine group. WHAT DOES THIS STUDY ADD?: Little is known about the safety and quality of prehospital analgesia carried out by emergency medical services (EMS). Beside potential quality problems, in some countries meaningful pain reduction is limited by legal regulations that allow only physicians to administer analgesics. This first multicentre prospective trial for telemedically delegated analgesia demonstrates that remote analgesia is possible and safe and retains equivalent analgesic quality compared with that administered by onsite EMS physicians. [ABSTRACT FROM AUTHOR]

Aim: This study examined the impact of fluctuations in metabolic control on the intelligence quotient (IQ) of children and adolescents with early, continuously treated phenylketonuria (PKU).Methods: This was a clinic-based study carried out at University Hospital Munster, Germany, from 2015 to 2017. We investigated 49 patients (28 boys) with early treated PKU, who were aged 6-18 years with a mean age of 11.2 ± 4.1 years. All the patients were on a continuous phenylalanine-restricted diet. Of the 49 patients, 29 (18 boys) had classic PKU and 21 patients (11 girls) had mild PKU. The patients' blood phenylalanine levels were assessed every week for 26 weeks and analysed for fluctuations, indicated by the standard deviation of the individual blood phenylalanine levels. We also assessed the concurrent Full Scale IQ (FSIQ) of the patients.Results: In patients with classic PKU, FSIQ was negatively correlated with blood phenylalanine levels, but not with level fluctuations. In patients with mild PKU, FSIQ was not correlated with blood phenylalanine levels, but was negatively correlated with level fluctuations.Conclusion: The blood phenylalanine levels of patients with mild PKU showed minor interindividual differences, which may have allowed fluctuations to exert a negative effect on the FSIQ. [ABSTRACT FROM AUTHOR]

Though it is frequently assumed that the college experience can influence our life goals, this claim has been relatively understudied. The current study examined the role of goals in college major selection, as well as whether major selection influences later goal change. In addition, we examined whether a person's perceptions of his or her peers' goals influence goal setting. Using a sample of German students (Mage  = 19 years; n = 3,023 at Wave 1), we assessed life goal levels and changes from high school into college across three assessment occasions. Participants reported their current aspirations, along with the perceived goals of their peers during the college assessments. Using latent growth curve models, findings suggest that life goals upon entering college significantly predict the majors students select. However, this major selection had limited influence on later changes in life goals. Stronger effects were found with respect to perceptions of peers' goals, with students tending to change their goals to better align with their peers. The current study provides evidence that life goals are relatively stable and yet can change during the emerging adult years, in ways that demonstrate the potential influence of the college experience. [ABSTRACT FROM AUTHOR]

As the world's population increasingly relies on the use of modern technology, cyberbullying becomes an omnipresent risk for children and adolescents and demands counteraction to prevent negative (online) experiences. The classroom-based German preventive intervention "Medienhelden" (engl.: "Media Heroes") builds on previous knowledge about links between cognitive empathy, affective empathy, and cyberbullying, among others. For an evaluation study, longitudinal data were available from 722 high school students aged 11-17 years (M = 13.36, SD = 1.00, 51.8% female) before and six months after the implementation of the program. A 10-week version and a 1-day version were conducted and compared with a control group (controlled pre-long-term-follow-up study). Schools were asked to randomly assign their participating classes to the intervention conditions. Multi-group structural equation modeling (SEM) showed a significant effect of the short intervention on cognitive empathy and significant effects of the long intervention on affective empathy and cyberbullying reduction. The results suggest the long-term intervention to be more effective in reducing cyberbullying and promoting affective empathy. Without any intervention, cyberbullying increased and affective empathy decreased across the study period. Empathy change was not generally directly linked to change in cyberbullying behavior. "Media Heroes" provides effective teaching materials and empowers schools to address the important topic of cyberbullying in classroom settings without costly support from the outside. [ABSTRACT FROM AUTHOR]

Dementia is becoming a major health burden, which is mainly due to the increasing life expectancy in many developed countries. To describe the disease progression of individuals, multistate models are generally appropriate tools. These models allow the individuals to move along a path consisting of a finite number of disease states. We consider a simplifying illness-death model in which the subjects progress through the states healthy, diseased and dead. We use this model to study analytic relationships between the prevalence, incidence and mortality rates of irreversible diseases that have been applied in the past. One of these approaches is a rather recently proposed technique based on an ordinary differential equation (ODE). We conduct a simulation study to compare the performance of two suggested numerical approximations of this ODE with three alternative techniques, the common goal of which is to estimate age-specific incidence from cross-sectional information. The quality of the estimation methods is further explored using data on dementia in Germany. In the simulation scenarios as well as in the dementia data setting, the ODE method turns out to be the predominant technique with regard to the quality of the estimation of the known incidence regimes. [ABSTRACT FROM AUTHOR]

There has been a debate on whether cost-effectiveness analysis should consider the cost of consumption and leisure time activities when using the quality-adjusted life year as a measure of health outcome under a societal perspective. The purpose of this study was to investigate whether the effects of ill health on consumptive activities are spontaneously considered in a health state valuation exercise and how much this matters. The survey enrolled patients with inflammatory bowel disease in Germany (n = 104). Patients were randomized to explicit and no explicit instruction for the consideration of consumption and leisure effects in a time trade-off (TTO) exercise. Explicit instruction to consider non-health-related utility in TTO exercises did not influence TTO scores. However, spontaneous consideration of non-health-related utility in patients without explicit instruction (60% of respondents) led to significantly lower TTO scores. Results suggest an inclusion of consumption costs in the numerator of the cost-effectiveness ratio, at least for those respondents who spontaneously consider non-health-related utility from treatment. Results also suggest that exercises eliciting health valuations from the general public may include a description of the impact of disease on consumptive activities. [ABSTRACT FROM AUTHOR]

Objectives To determine how nursing staff evaluate nonverbal behavior related to hand and tube feeding of residents with dementia. Design Cross-sectional survey. Setting A stratified sample of nurses and nursing assistants in residential nursing homes in a major German city. Participants Nursing staff members (N = 131) in 12 nursing homes. Measurements Nursing staff perception of nonverbal behavior of residents with dementia in response to hand and tube feeding. Results Ninety-three percent of survey participants considered the nonverbal behavior of residents with advanced dementia crucial for decisions about artificial nutrition and hydration ( ANH). The same percentage had at some point encountered residents who did not open their mouths when feeding was attempted. Fifty-three percent of the participants interpreted residents' expressions of pleasure while eating as a will to live. The most frequent interpretation of residents' aversive behavior was discomfort. When residents did not open their mouth during nurse's hand feeding, 41% of the participants inferred a will to die. Conclusion Most nurses and nursing assistants consider residents' behavior during hand or tube feeding to be important, but their interpretations are heterogeneous. Various professional caregivers assume a will to live or die. Further reflection is necessary to determine how behavioral expressions should be factored into treatment decisions. [ABSTRACT FROM AUTHOR]

Aim We investigated the long-term impact of adjunctive systemic antibiotics on periodontal disease progression. Periodontal therapy is frequently supplemented by systemic antibiotics, although its impact on the course of disease is still unclear. Material & Methods This prospective, randomized, double-blind, placebo-controlled multi-centre trial comprising patients suffering from moderate to severe periodontitis evaluated the impact of rational adjunctive use of systemic amoxicillin 500 mg plus metronidazole 400 mg (3x/day, 7 days) on attachment loss. The primary outcome was the percentage of sites showing further attachment loss ( PSAL) ≥1.3 mm after the 27.5 months observation period. Standardized therapy comprised mechanical debridement in conjunction with antibiotics or placebo administration, and maintenance therapy at 3 months intervals. Results From 506 participating patients, 406 were included in the intention to treat analysis. Median PSAL observed in placebo group was 7.8% compared to 5.3% in antibiotics group (Q25 4.7%/Q75 14.1%; Q25 3.1%/Q75 9.9%; p < 0.001 respectively). Conclusions Both treatments were effective in preventing disease progression. Compared to placebo, the prescription of empiric adjunctive systemic antibiotics showed a small absolute, although statistically significant, additional reduction in further attachment loss. Therapists should consider the patient's overall risk for periodontal disease when deciding for or against adjunctive antibiotics prescription. [ABSTRACT FROM AUTHOR]

The article focuses on the serologic and molecular characterization of weak D phenotype 29. Topics discussed include inclusion of Rhesus box with rheumatic heart disease allele in a blood donor from a Caucasoid population; nucleotide variations of weak D type 29; and extraction of DNA from Ethylenediaminetetraacetic acid-anticoagulated whole blood samples.

ABSTRACT Background Diaries written for patients in the Intensive Care Unit ( ICU) have been used in many European countries since the early 1990s to support patients and their relatives in their understanding of the ICU experience. ICU diaries have been introduced in Germany since 2008 via the internet, newsletters, newspapers, lectures and publications in German nursing journals. Aim The aim of the study was to update our knowledge of the extent and application of ICU diaries in Germany in 2014. Design The study had a prospective mixed methods multicenter design. Method All 152 ICUs in the two German federal states of Baden-Württemberg and Schleswig-Holstein were surveyed to identify units that had implemented ICU diaries. An additional 69 ICUs from other parts of Germany were included in the survey. We excluded diaries used in neonatal ICUs. Out of 43 units using diaries 14 were selected for semi-structured key-informant telephone-interviews on the application of ICU diaries. Results According to the survey, 8 out of 152 ICUs in the two federal states of Baden-Württemberg and Schleswig-Holstein had implemented ICU diaries and another six were planning implementation. Another 35 ICUs in other areas of Germany had implemented diaries and three units were planning to do so. Interviews were conducted with nurses at 14 selected ICUs. Informants reported successful adaption of the diary concept to their culture, but variability in application. No units were identified where all nursing staff participated in keeping ICU diaries. Conclusion Six years after the introduction of ICU diaries, ICU nurses in Germany are becoming familiar with the concept. Nursing shortage and bureaucratic challenges have impeded the process of implementation, but the adaption of ICU diaries to German conditions appears to be successful and is still in progress. Relevance to Clinical Practice Implementation of ICU diaries is feasible after adjusting for cultural and legal issues. [ABSTRACT FROM AUTHOR]