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Universities have increasingly been subjected to policy- and industry demands to produce multi- and interdisciplinary knowledge. This paper explores the extent to which different higher education policy instruments are used to promote interdisciplinarity in teaching and research at universities in the German higher education system comparing them across different federal states. Based on a manifest content analysis of higher education laws and performance agreements with universities in the 16 German states, we were able to distinguish between three types of states: Those a) with a general use of policy instruments aimed at all universities in a state, whereas considerable differences could be observed with regard to the degree of coercion (enabling versus prescriptive provisions) and scope (teaching or research), b) a directed use of policy instrument, targeting specific universities, and c) a hybrid use of policy instruments using both general and directed elements. This paper provides a novel mapping of the promotion of interdisciplinarity in German higher education policies through a variety of policy instruments and hereby contributes to the extant literature on interdisciplinarity in higher education.

The benefits of inclusive practices for students with intellectual disabilities have been demonstrated in several countries; however, large-scale inclusive practices remain elusive. Having a clear understanding of how researchers define the terms inclusion and intellectual disability would support more cross-cultural collaboration and facilitate the generalization of practices. Addressed in this paper is the question of what themes, if any, exist in conceptualizing inclusion and intellectual disability across the peer-reviewed research of six countries, three of which have been identified as highly inclusive and three that have been identified as minimally inclusive. These findings may be used to further research into barriers and opportunities for inclusive practices for students with intellectual disabilities.

Purpose: To give an overview of the multicenter Prostate Cancer Outcomes (PCO) study, involving paper-based and web-based collection of patient-reported outcome measures (PROM) in patients undergoing local treatment for prostate cancer in certified centers in Germany. The PCO study is part of the larger Movember-funded TrueNTH Global Registry. The article reports on the study's design and provides a brief progress report after the first 2 years of data collection. Methods: Prostate cancer centers (PCCs) certified according to German Cancer Society requirements were invited to participate in collecting patient-reported information on symptoms and function before and at least once (at 12 months) after treatment. The data were matched with disease and treatment information. This report describes progress in patient inclusion, response rate, and variations between centers relative to online/paper use, and also data quality, including recruitment variations relative to treatment in the first participating PCCs. Results: PCC participation increased over time; 44 centers had transferred data for 3094 patients at the time of this report. Patient recruitment varied widely across centers. Recruitment was highest among patients undergoing radical prostatectomy. The completeness of the data was good, except for comorbidity information. Conclusions: The PCO study benefits from a quality improvement system first established over 10 years ago, requiring collection and harmonization of a predefined clinical dataset across centers. Nevertheless, establishing a PROM routine requires substantial effort on the part of providers and constant monitoring in order to achieve high-quality data. The findings reported here may be useful for guiding implementation in similar initiatives. [ABSTRACT FROM AUTHOR]

In our paper, we aim to give an overview about the emergence and evolvement of the history of education in Hungary. Nevertheless, we intend to surpass the traditional approach of giving a schematic description of these processes as we would like to depict the interconnectedness of the Hungarian history of education with the European research tendencies and the thematic variety of the Hungarian research activities. We used literature analysis, historical source analysis and descriptive statistical analysis as primary methods. Within Hungary, we pay special attention to the University of Budapest but we also reflect special peculiarities regarding the other full universities in the country. The Hungarian history of education followed the pathway of the German-speaking countries regarding the approach and the function until 1948. History of education had a self-legitimising role in the emerging national education system and modernised university environment; however, this characteristic feature did not exclude the incorporation of international research approaches. This function was slightly altered in the interwar period since leading researchers of the subfield contributed to maintaining the ideological coherence of the political structure. During the socialist period, researchers were expected to follow the directives of their Soviet colleagues; however, in the 1970s the homogeneity in themes and research approaches began loosening. As the result of the political regime change in 1989/1990, Hungarian research was given an opportunity to be integrated into the European exchange of ideas and implement research approaches prevalent in Western countries.

The 11th Revision of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD-11) will replace its predecessor as international standard for cause-of death-statistics. The digitization of healthcare is a main motivation for its introduction. In parallel, the replacement of the paper-based death certificate with an electronic format is under evaluation. At the moment, the death certificate is used in paper-based format with ICD-10 for coding in Germany. To be prepared for the switch to ICD-11, the compatibility between ICD-11 and the electronic certificate should be assured. Objectives were to check the appropriateness of diagnosis-related information found on death certificates for an ICD-11 coding and to describe enhancements to the certificate's structure needed to fully utilize the strengths of ICD-11. As part of an exploratory test of a respective application, information from 453 electronic death certificates were provided by one local health authority. From a sample of 200 certificates, 433 diagnosis texts were coded into the German version of ICD-11. The appropriateness of the results as well as the further requirements of ICD-11, particularly with regard to post-coordination, were checked. For 430 diagnosis texts, 649 ICD-11 codes were used. Three hundred and sixty two diagnosis texts were rated as appropriately represented through the coding result. Almost all certificates contained diagnosis texts that lacked details required by ICD-11 for a precise coding. The distribution of diseases was very similar between ICD-10 and ICD-11 coding. A few gaps in ICD-11 were identified. Information requested by ICD-11 for a mandatory post-coordination were almost entirely absent from the death certificates. The structure and content of the death certificate are currently not well prepared for an ICD-11 coding. Necessary information was frequently missing. The line-oriented structure of death certificates has to be supplemented with a more flexible approach. Then, the semantic knowledge base of ICD-11 should better guide the content related input fields of a future electronic death certificate. [ABSTRACT FROM AUTHOR]

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.

Interdisciplinary research is a popular mode of knowledge production that becomes intensively promoted by research centers all across the globe. Despite the facilitation of interdisciplinary research, however, scholars working in these centers are 'disciplined.' Career promotions, funding decisions and scientific publishing are based on peer-review procedures that tend to favor monodisciplinary research. This paper builds on a qualitative study with scholars in interdisciplinary research centers in Germany and asks how scholars cope with these monodisciplinary demands. After deriving a conceptual framework, the study identifies four coping strategies: disciplinary innovation, strategic compliance, niche-seeking, and field creation. Each of these strategies is characterized by a different degree of openness to knowledge bases of other disciplines and a different degree of proactivity towards monodisciplinary demands from the scientific field. The results illuminate how research agendas become disciplined despite interdisciplinary motivation and organizational support of interdisciplinary research.

Research on engineering practice is scarce and sharing of qualitative research data can reduce the effort required for an aspiring researcher to obtain enough data from engineering workplaces to draw generalizable conclusions, both qualitative and quantitative. This paper describes how a large shareable qualitative data set on engineering practices was accumulated from 350 interviews and 12 field studies performed by the principal investigator and by students conducting PhD and capstone research projects. Ethical research practice required that sharing and reuse of qualitative data be considered from the start. The researchers' interests and methods were aligned to maintain sufficient consistency to support subsequent analysis and re-analysis of data. Analysis helped to answer questions of fundamental significance for engineering educators: what do engineers do, and why are the performances of engineering enterprises so different in South Asia compared with similar enterprises in Australia? Analysis also demonstrated the overwhelming significance of technical collaboration in engineering practice. Conceiving engineering practice as a series of technical collaboration performances requires a more elaborate understanding of social interactions than is currently the case in engineering schools. Another finding is that global engineering competency could be better described in terms of "working with people who collaborate differently". Research helped to demonstrate that formal treatment of technical collaboration in an engineering curriculum could help avoid student misconceptions about engineering practice that hinder their subsequent engineering performances.

This article contributes to the understanding of how different actors in the academic field perceive the challenges that Brexit poses for European higher education. Based on a narrative analysis of 28 interviews, this paper highlights how actors' narratives convene discursive elements stemming from competing discourses on cooperation and competition. In doing so, the exploratory study focuses on two countries, Portugal and Germany, which correspond to distinct cases regarding their performance in the European research and higher education landscape. The analysis highlights that there are national differences between the perceptions of Brexit and allows identifying commonalities in the narratives in both countries. In addition, we identify the presence of a pragmatic managerial attitude in response to Brexit. The three overarching narratives are the narrative of concerns, the narrative of hopes, and the narrative of beliefs. These narratives reflect the struggle of the cooperation and the competition discourses in ascribing meaning to Brexit. The competition discourse has assumed a dominant role in the perceptions of Brexit and cooperation is mainly fueled through the academics and their professional ethos.

In this paper, we focus on the institutionalization of transdisciplinarity (TD) in higher education institutions and how they institutionalize Transdisciplinarity (TD). As such, universities have engaged in different activities to enact TD policies that aim at incorporating TD in their research and teaching. We take the Methodology Center at the Leuphana University of Lüneburg as a case study. We analyze the institutionalization process of TD to shed light on the obstacles that TD faces to become a widespread policy and practice at universities. In adopting a neo-institutionalist approach in our research, we develop a two-level analysis that allow us to compare the formal characteristics given to TD policies with the actual TD practices taking place in universities. Our findings reveal that TD institutionalization at the Methodology Center is at a mid-level and that overall TD institutionalization is an iterative process, in which the two levels mutually can reinforce or hinder each other.

General practices are rooted in the local community and considered to be particularly well‐positioned for engaging in preventive and health‐promoting activities. The overall aim of the scoping review is to identify priorities and gaps in research published in the past 20 years on preventive and health‐promoting activities provided by general practitioners or their teams in general practices in Germany. MEDLINE and Embase databases were systematically searched in November 2020. Papers were selected in dual‐review mode and extracted in single‐review mode. Data analysis was finished by May 2021. In total, 530 papers were included in the synthesis. Little research has been carried out into collaboration opportunities both within the general practice team and in communities as a whole, with specialists (18%), hospitals (9%), and health insurance companies (6%) being the most frequent cooperation partners of GPs. 15%–20% of papers each dealt with 'early detection', 'information provision' and 'cardiovascular prevention'. Secondary (53%) and tertiary prevention (43%) was more often the subject of research than primary (39%) and quaternary prevention (15%). Healthy subjects (26%) were less often studied than people with pre‐existing conditions (42%) and risk factors (48%). Little information was available on preventive activities in terms of gender, young people, migration background, housing conditions or educational background. Personal counselling (15%) was the most frequently described approach to health promotion in general practices, along with printed information materials (10%). This scoping review provides information on which to base targeted interventions and future research that can contribute towards transforming general practices into promoters of health within the community. [ABSTRACT FROM AUTHOR]

An ongoing debate in the literature on the efficiency of higher education institutions concerns the indicator for research output for use in empirical analysis. While several studies have chosen to use the number of publications as this indicator, others rely on the amount of research grants. The present study investigates whether both measures lead to a similar assessment of universities. In addition, the number of publications belonging to the 10% and 1% most frequently cited papers in the corresponding subject category and publication year are evaluated. We show that there is a high correlation of efficiency values between the estimations using these indicators. This correlation is slightly higher when the efficiency values result from a data envelopment analysis than when they are determined with a stochastic frontier analysis. The results of this study provide helpful guidelines for researchers evaluating the efficiency of universities and are valueable for decision-makers in science policy.

Student success is among the most widely researched areas in tertiary education. Generalisability of research in this field is problematic due to cultural and structural differences between countries, institutions and programmes where the research is done. Engineering education in the Netherlands has not been studied in depth. In this paper, outcomes of studies done outside and inside engineering and outside and inside the Netherlands are discussed to help understand the complexity of student retention issues. Although generalisation is an issue, there are a number of concepts and variables that surface in many of these studies, including students' background and disposition variables, education attributes, variables concerning educational climate and student behaviour. How these variables are related and how a university can apply the outcomes of research in this field of study are discussed in this paper. (Contains 1 table, 3 figures and 2 notes.)

This paper is situated in relation to a critical mass of largely censorious commentary around global policy trends purportedly undermining, or even realigning, universities' 'traditional' ethos, but where the student perspective on this appears to have been largely ignored. Drawing on interviews with German and English undergraduates, it applies the neo-institutional theory of organizational fields supported by regulative, cognitive, and normative pillars (Scott 1995. "Institutions and Organizations." Thousand Oaks: Sage). The latter pillar, representing a sector's values, methods, and goals, is of particular interest here, and it will be argued that this and an ethos may correspond. The findings show that a sense of the participants' understanding of a university ethos/normative pillar could be discerned, with significant convergence between the two groups. However at the same time there was also divergence both within and between them, and this raises a number of novel empirical and theoretical questions.

Objectives: Medical education is gaining in significance internationally. A growing interest in the field has been observed in German-speaking countries (Austria, Germany, Switzerland) since the early 2000s. This interest is not, however, reflected in an increase in the number of publications on medical education of German-speaking authors in international professional journals. The following investigation examines the potential use of active participant numbers of German-speaking researchers at AMEE conferences as a means of measuring said development., Methods: The AMEE conference proceedings from the categories poster presentations, short communications, research papers and plenary presentations from the years 2005-2013 were examined for evidence of Austrian, German and Swiss participation. The abstracts were subsequently analysed in terms of content and categorised according to study design, methodology, object of study, and research topic., Results: Of the 9,446 analysed abstracts, 549 contributions show at least one first, last or co-author from Austria, Germany or Switzerland. The absolute number of contributions per conference varied between 44 in 2010 and 77 in 2013. The percentage fluctuated between 10% in 2005 and 4.1% in 2010. From the year 2010 onwards, however, participation increased continually. The research was predominantly descriptive (62.7%). Studies on fundamental questions of teaching and learning (clarification studies) were less frequent (4.0%). For the most part, quantitative methods (51.9%) were implemented in addressing subjects such as learning and teaching methods (33%), evaluation and assessment (22.4%) or curriculum development (14.4%). The study population was usually comprised of students (52.5%)., Conclusions: The number of contributions from Austria, Germany and Switzerland peak at the beginning and at the end of the evaluated period of time. A continual increase in active participation since 2005 was not observed. These observations do not reflect the actual increase of interest in medical education research in German-speaking countries.

Background: The hypothesis that distance matters but that in recent years geographical proximity has become less important for research collaboration was tested. We have chosen a sample-authors at German immunological institutes-that is relatively homogeneous with regard to research field, language and culture, which beside distance are other possible factors influencing the willingness to co-operate. We analyse yearly distributions of co-authorship links between institutes and compare them with the yearly distributions of distances of all institutes producing papers in journals indexed in the Science Citation Index, editions 1992 till 2002. We weight both types of distributions properly with paper numbers. Results: One interesting result is that place matters but if a researcher has to leave the home town to find a collaborator distance does not matter any longer. This result holds for all years considered, but is statistically most significant in 2002. The tendency to leave the own town for collaborators has slightly increased in the sample. In addition, yearly productivity distributions of institutes have been found to be lognormal. Conclusion: The Internet did not change much the collaboration patterns between German immunological institutes. [ABSTRACT FROM AUTHOR]

This paper explores the link between the composition and the performance of junior research groups. The authors argue that the heterogeneity-performance link depends on the type of heterogeneity (cultural vs. study field) and on the disciplinary area. The authors test their hypotheses on a data set of 45 junior research groups and find a U-shaped relation between cultural heterogeneity and performance in the humanities and social sciences, but no link between the two in the natural sciences. The link between study field heterogeneity and performance in the natural sciences is negative, and in the humanities and social sciences study field heterogeneity and performance are not related. Interaction within the group helps reap the benefits of heterogeneity. The study results are derived in the context of junior research groups in Germany, but are generalizable to other countries and contexts where PhD education is taking part in groups.

Introduction: The digitalisation of the German healthcare system enables a wide range of opportunities to utilize healthcare data. The implementation of the EHR in January 2021 was a significant step, but compared to other European countries, the implementation of the EHR in the German healthcare system is still at an early stage. The aim of this paper is to characterise the structural factors relating to the adoption of the EHR in more detail from the perspective of representatives of stakeholders working in the German healthcare system and to identify existing barriers to implementation and the need for change. Methods: Qualitative expert interviews were conducted with one representative from each of the stakeholder groups health insurance, pharmacies, healthcare research, EHR development and panel doctors. Results: The interviews with the various stakeholders revealed that the implementation process of the EHR is being delayed by a lack of a viable basis for decision-making, existing conflicts of interest and insufficient consideration of the needs of patients and service providers, among other things. Discussion: The current status of EHR implementation is due to deficiency in legal regulations as well as structural problems and the timing of the introduction. For instance, the access rights of various stakeholders to the EHR data and the procedure in the event of a technical failure of the telematics infrastructure are remain unclear. In addition, insufficient information and communication measures have not led to the desired acceptance of EHR use among patients and service providers. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 serology may be helpful to retrospectively understand infection dynamics in specific settings including kindergartens. We assessed SARS-CoV-2 seroprevalence in individuals connected to kindergartens in Berlin, Germany in September 2021. Children, staff, and household members from 12 randomly selected kindergartens were interviewed on COVID-19 history and sociodemographic parameters. Blood samples were collected on filter paper. SARS-CoV-2 anti-S and anti-N antibodies were assessed using Roche Elecsys. We assessed seroprevalence and the proportion of so far unrecognized SARS-CoV-2 infections. We included 277 participants, comprising 48 (17.3%) kindergarten children, 37 (13.4%) staff, and 192 (69.3%) household members. SARS-CoV-2 antibodies were present in 65.0%, and 52.7% of all participants were vaccinated. Evidence of previous infection was observed in 16.7% of kindergarten children, 16.2% of staff, and 10.4% of household members. Undiagnosed infections were observed in 12.5%, 5.4%, and 3.6%, respectively. Preceding infections were associated with facemask neglect. In conclusion, two-thirds of our cohort were SARS-CoV-2 seroreactive in September 2021, largely as a result of vaccination in adults. Kindergarten children showed the highest proportion of non-vaccine-induced seropositivity and an increased proportion of previously unrecognized SARS-CoV-2 infection. Silent infections in pre-school children need to be considered when interpreting SARS-CoV-2 infections in the kindergarten context. [ABSTRACT FROM AUTHOR]

Reports on the controversy created by a stem cell paper by a team of German biologists published in the 2004 issue of "Applied Physics". Public announcement of the research as a breakthrough in adult stem-cell technology; Protests against research using embryonic lines; Criticisms of the research.

Reports on the retraction of a three year old of a research paper in "Nature Medicine" on a cancer vaccine. German scientists who admit to several incorrect statements; Erroneous presentation of data, results and conclusions; Retraction the result of an investigation by an ombudsman's committee from Göttingen University.

The years between 2005 and 2014 have been declared as a worldwide Decade of Education for Sustainable Development (DESD) by the United Nations. DESD's intended purpose is to promote and more thoroughly focus education as a crucial tool preparing young people to be responsible future citizens, so that our future generations can shape society in a sustainable manner. All educational levels and domains are to be involved in contributing to ESD, including chemistry. This paper reflects upon the meaning of the UN's challenge and on what ESD pedagogy will mean for chemistry education. Additionally, it provides an overview of different models suggesting how such integration of sustainability issues can be compatible with chemistry education. Various consequences and implications arising from this approach will also be discussed. (Contains 1 table and 2 figures.)

This paper is a macro study on higher education R&D and its impact on productivity growth. I measure the social rate of return on higher education R&D in 17 high-income OECD countries using country level data on the percentage of gross expenditure on R&D performed by higher education, business, and government sectors over the period 1981-2006. Empirical results suggest that lagged R&D performed by higher education is positively affecting productivity growth in all specifications. The long-run propensity of productivity growth to R&D performed by the higher education sector is also found to be positive and significant while it is found be insignificant to business R&D. (Contains 13 notes, 3 figures and 8 tables.)

Presents an article that assesses the work experiences of Ann Holbourn, a geoscientist at Christian Albrechts University in Kiel, Germany. Research study on Miocene epoch; Details of the study; Success of the drilling approach; Results of the study shows that Holbourn and her team found drastic changes in both oxygen and carbon isotopes.

Background: To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients' perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients' preferences on assessing PROMs after ischemic stroke. Methods: A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics. Results: 158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15–30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication. Conclusions: For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care. [ABSTRACT FROM AUTHOR]

A theory of university autonomy is evolved that considers such elements as research, student recruitment and admission, physical environment, and administrative organization. The higher education systems of Sweden (before and after reform), Germany, the United States, and Britain are compared. (MSE)

College students have been recognized as a risk group for substance use. Nevertheless, coherent risk factors for stimulant use remain to be elucidated. The objective of this paper is to identify risk factors associated with the recreational use of MDMA, cocaine, amphetamine and methamphetamine. An online questionnaire was distributed among colleges in Berlin. A sample of 12,914 college students participated, of which 9,382 met the inclusion criteria. Past-month prevalence was 7.0% for MDMA, 6.7% for amphetamine, 5.8% for cocaine and 0.1% for methamphetamine. Associated factors included male gender, "other" gender, homosexual and bisexual orientation, open relationship status or being single, engaging in sexual risk-taking behavior, having a psychiatric diagnosis, tobacco use, drinking alcohol and an increased number of (illicit) substances consumed in the past month and in life. Berlin college students showed a substantially higher prevalence of stimulant use compared to both the general population and college students in other cities. Certain parameters, e.g., polydrug use, were particularly high in this group. The results can be used in further development of prevention efforts. However, conclusions about causality are limited by the cross-sectional nature of this study, highlighting the necessity for longitudinal studies in this field. [ABSTRACT FROM AUTHOR]

Discusses incentives for basic research, which were recently introduced in the German Institute for Economic Research, including both team and individual incentives. Possible problems arise from focussing on the measurable, crowding out intrinsic motivation and undesirable externalities. Furthermore, provides survey evidence on the perception of the incentives by the institute's researchers. [ABSTRACT FROM AUTHOR]

Reviews research on problem behavior in adolescence. Discusses implications of this research, distinguishing between different stages in the process by which problem behavior emerges and separates "preventive" from "corrective" forms of intervention. Discusses implications for social policy. (Author/ABL)

Health technology assessments (HTAs) are used as a policy tool to appraise the clinical value, or cost effectiveness, of new medicines to inform reimbursement decisions in health care. As HTA organisations have been established in different countries, it has become clear that the outcomes of medicine appraisals can vary from country to country, even though the same scientific evidence in the form of randomised controlled trials is available. The extant literature explains such variations with reference to institutional variables and administrative rules. However, little research has been conducted to advance the theoretical understanding of how variations in HTA outcomes might be explained. This paper compares cases of HTA in England and Germany using insights from Kuhn (1962, The Structure of Scientific Revolutions, 2nd edn. Chicago: The University of Chicago Press) and Hall (1993, Policy paradigms, social learning, and the state: the case of economic policymaking in Britain. Comparative Politics 25, 275-296) to demonstrate how policy paradigms can explain the outcomes of HTA processes. The paper finds that HTA outcomes are influenced by a combination of logical issues that require reasoning within a paradigm, and institutional and political issues that speak to the interaction between ideational and interest-based variables. It sets out an approach that advances the theoretical explanation of divergent HTA outcomes, and offers an analytical basis on which to assess current and future policy changes in HTA. [ABSTRACT FROM AUTHOR]

The paper reports the results of an exploratory online survey among German, Austrian, and Swiss hospital chaplains (n = 158, response rate 17%) to identify the ethical conflicts they encounter in their work. Respondents indicated that questions surrounding end-of-life care are predominant among the conflicts faced. Chaplains get involved with these conflicts most often through the patients themselves or through nursing staff. Most encounters occur during pastoral care visits rather than in structured forms of ethics consultation such as clinical ethics committees. The results add to the ongoing discussion of chaplains as agents in ethics consultation within healthcare systems as well as their specific role and contribution. [ABSTRACT FROM AUTHOR]

Background: Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sample of adolescents with mental health problems. Here, we investigated the association between conspiracy beliefs and guideline adherence while also exploring the predictors of conspiracy beliefs. Methods: N = 93 adolescent psychiatric outpatients (57% female, mean age: 15.8) were assessed using anonymous paper–pencil questionnaires. Endorsement of generic and COVID-19 conspiracy beliefs was assessed, in addition to items measuring adherence to protective guidelines and mental health (stress, depressive symptoms, emotional/behavioral problems, and adverse childhood experiences). Multiple regressions and supervised machine learning (conditional random forests) were used for analyses. Results: Fourteen percent of our sample fully endorsed at least one COVID-19 conspiracy theory, while protective guidelines adherence was relatively high (M = 4.92, on a scale from 1 to 7). The endorsement of COVID-19 conspiracy beliefs—but not of generic conspiracy beliefs—was associated with lower guideline adherence (β = − 0.32, 95% CI − 0.53 to − 0.11, p <.001). Conditional random forests suggested that adverse childhood experiences and peer and conduct problems were relevant predictors of both conspiracy belief categories. Conclusion: While a significant proportion of our sample of adolescents in psychiatric treatment endorsed conspiracy beliefs, the majority did not. Furthermore, and to some degree, contrary to public perception, we found that adolescents show relatively good adherence to public health measures—even while experiencing a high degree of mental distress. The predictive value of adverse childhood experiences and peer/conduct problems for conspiracy beliefs might be explained by compensatory mechanisms to ensure the safety, structure, and inclusion that conspiracies provide. [ABSTRACT FROM AUTHOR]

Background: Research has shown that routinely assessed, patient-reported outcome measures (PROMs) have positive effects in patients with advanced oncologic diseases. However, the transferability of these results to specialist palliative care is uncertain because patients are more impaired and staff doubt the feasibility and benefits. The aim of this study is to evaluate the feasibility of patient self-assessment of PROMs, their use by staff and the benefits in palliative care wards. Method: A multicentre observational study was conducted in the context of the implementation of the Integrated Patient Outcome Scale (IPOS) in three specialist palliative care wards at university hospitals in Germany. All admitted patients who screened positive regarding their ability to complete questionnaires were asked to participate and complete the IPOS on paper weekly, with assistance if necessary. Feasibility of questionnaire completion (e.g. proportion of patients able to complete them), use (e.g. involvement of different professional groups) and benefit (e.g. unexpected information in IPOS as rated by treating physicians) were assessed. Staff members' opinion was obtained in a written, anonymous evaluation survey, patients' opinion in a short written evaluation. Results: A total of 557 patients were screened for eligibility, 235 were assessed as able to complete the IPOS (42.2%) and 137 participated in the study (24.6%). A majority needed support in completing the IPOS; 40 staff members and 73 patients completed the evaluation. Unexpected information was marked by physicians in 95 of the 137 patient questionnaires (69.3%). The staff differed in their opinions on the question of whether this also improved treatment. A majority of 32 staff members (80.0%) were in favour of continuing the use of IPOS (4 against continuation, 4 no answer); 43 (58.9%) patients rated their overall experience of IPOS use as 'positive', 29 (39.7%) as 'neutral' and 1 (1.4%) as 'negative'. Conclusions: While most staff wished to continue using IPOS, it was a challenge to integrate the effort to support the completion of IPOS into daily practice. Digital implementation was not successful, despite various attempts. To explore the effects on care and patient outcomes, multicentre cluster-randomised trials could be employed. Trial registration: German Clinical Trials Register DRKS-ID: DRKS00016681 (24/04/2019). [ABSTRACT FROM AUTHOR]

Background: Complementary medicine (CM) is frequently used by patients, but little is known about the usage of CM in surgical patients. The study aimed to elucidate the relevance of CM in surgery. Methods: This cross-sectional, multi-center survey utilized a paper-based questionnaire consisting of 21 questions to capture CM usage and interest as well as CM communication in visceral and thoracic surgical patients being hospitalized at the corresponding departments of surgery at the University Medical Centers in Freiburg, Heidelberg und Ulm, Germany. Results: Overall, 151 patients consented to the survey. On average, current CM usage was stated by 44% of patients. Most frequently used CM approaches were physical exercise (63%), nutritional supplements (59%) and herbal medicine (56%). Strong interest in CM counselling was stated by 51% of patients. Almost 80% of patients wanted to be treated in a holistic manner and desired for reliable information about CM as well as CM informed physicians. Only 12% of patients communicated CM usage and interest with their attending physician. Review of literature revealed similar results showing an overall CM usage of 43%, preferring nutritional supplements and herbal medicine. Conclusion: The results of our cross-sectional study indicate a high percentage of CM users and a strong interest in CM among surgical patients. Indeed, the current communication about CM between patients and surgeons is poor. With respect to safety and quality reasons, but also to pay attention to patients' demands, physicians should be aware of patients' CM usage in surgery. Trial registration: German Clinical Trial register (DRKS00015445). [ABSTRACT FROM AUTHOR]

Background: Medical data from family doctors are of great importance to health care researchers but seem to be locked in German practices and, thus, are underused in research. The RADAR project (Routine Anonymized Data for Advanced Health Services Research) aims at designing, implementing and piloting a generic research architecture, technical software solutions as well as procedures and workflows to unlock data from family doctor's practices. A long-term medical data repository for research taking legal requirements into account is established. Thereby, RADAR helps closing the gap between the European countries and to contribute data from primary care in Germany.Methods: The RADAR project comprises three phases: (1) analysis phase, (2) design phase, and (3) pilot. First, interdisciplinary workshops were held to list prerequisites and requirements. Second, an architecture diagram with building blocks and functions, and an ordered list of process steps (workflow) for data capture and storage were designed. Third, technical components and workflows were piloted. The pilot was extended by a data integration workflow using patient-reported outcomes (paper-based questionnaires).Results: The analysis phase resulted in listing 17 essential prerequisites and guiding requirements for data management compliant with the General Data Protection Regulation (GDPR). Based on this list existing approaches to fulfil the RADAR tasks were evaluated-for example, re-using BDT interface for data exchange and Trusted Third Party-approach for consent management and record linkage. Consented data sets of 100 patients were successfully exported, separated into person-identifying and medical data, pseudonymised and saved. Record linkage and data integration workflows for patient-reported outcomes in the RADAR research database were successfully piloted for 63 responders.Conclusion: The RADAR project successfully developed a generic architecture together with a technical framework of tools, interfaces, and workflows for a complete infrastructure for practicable and secure processing of patient data from family doctors. All technical components and workflows can be reused for further research projects. Additionally, a Trusted Third Party-approach can be used as core element to implement data privacy protection in such heterogeneous family doctor's settings. Optimisations identified comprise a fully-electronic consent recording using tablet computers, which is part of the project's extension phase. [ABSTRACT FROM AUTHOR]

Objective: The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.Methods: One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.Results: The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.Conclusions: For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis. [ABSTRACT FROM AUTHOR]

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]